United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

G.N., Appellant 

and 

DEPARTMENT OF THE ARMY, CORPUS 

CHRISTI ARMY DEPOT, Corpus Christi, TX, 

Employer 

__________________________________________ 

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Docket No. 16-1327 

Issued: December 27, 2016 

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

COLLEEN DUFFY KIKO, Judge 

ALEC J. KOROMILAS, Alternate Judge 

JURISDICTION 

On June 14, 2016 appellant filed a timely appeal from an April 26, 2016 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. 

 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 met his burden of proof to establish that he sustained an 

occupational disease claim causally related to factors of his employment. 

FACTUAL HISTORY 

On November 6, 2013 appellant, then a 66-year-old sandblaster, filed an occupational 

disease claim (Form CA-2) alleging that factors of his employment caused a hand, wrist, knee, 

and left shoulder condition. He alleged that he first became aware of his condition on June 6, 

2001 and its relation to his federal employment on September 18, 2013. Appellant attributed his 

condition to wear and tear from sandblasting for 29 years, which included holding parts at 45 to 

90 degree angles and derubbering parts. He retired on May 30, 2014. 

In a September 18, 2013 report, Dr. Praxton Longwell, a Board-certified neurologist, 

advised that appellant complained of bilateral arm and hand pain for the past 12 years that was 

worse on the left with nocturnal exacerbation. Examination revealed normal muscle tone, 

positive Tinel’s on percussion of the median nerves at both wrists, and median nerve 

hypoesthesia over both upper extremities. Dr. Longwell explained that an electromyogram 

(EMG) and nerve conduction velocity (NCV) study revealed significant bilateral carpal tunnel 

syndrome, more severe on the left. He indicated that appellant would likely benefit from 

surgical decompression, if he did not improve with conservative treatment. 

In a November 27, 2013 diagnostic report, Dr. Jennifer Turner, a Board-certified 

diagnostic radiologist, advised that a right hand x-ray revealed mild degenerative changes 

primarily affecting the thumb and atherosclerotic vascular disease. 

In a November 27, 2013 Texas Workers’ Compensation Work Status Report, Dr. James 

Rose, a family medicine practitioner, advised that appellant injured both hands on 

September 18, 2013. He noted that appellant was able to return to work that day without 

restrictions. In an unsigned November 27, 2013 report, appellant was diagnosed with bilateral 

carpal tunnel syndrome. The report described the injury as work related and noted that he 

worked as a sandblaster for the past 29 years. 

In a December 19, 2013 report, Dr. Robert Williams, a Board-certified orthopedic 

surgeon, advised that appellant was referred by Dr. Rose. He noted that appellant reported a 

long history of carpal tunnel syndrome and repetitive trauma while working at the employing 

establishment. Dr. Williams advised that bilateral wrist x-rays were unremarkable and noted that 

appellant elected to undergo an open carpal tunnel release surgery. He indicated that a 

September 18, 2013 EMG and NCV study revealed bilateral carpal tunnel syndrome worse on 

the left. 

By letter dated January 15, 2014, the employing establishment controverted appellant’s 

claim. It argued that medical evidence was insufficient to establish his claim as there was no 

physician’s opinion as to how the employment activities caused or contributed to the diagnosed 

condition. 
3

By letter dated January 30, 2014, OWCP advised appellant of the type of evidence 

needed to establish his claim and afforded him 30 days to submit responsive evidence. 

In a February 22, 2014 narrative statement, appellant advised that he worked as a 

sandblaster for 29 years. He noted that he experienced hand and wrist pain mainly on the left for 

years and advised that he used a wrist support since 1998. Appellant also noted that he was 

having problems with his left knee and shoulder. He also submitted evidence related to an 

October 16, 2000 work-related left shoulder injury where he hit his left shoulder on a door while 

entering the building. 

By decision dated July 17, 2014, OWCP denied appellant’s claim. It found that medical 

evidence of record was insufficient to establish that the diagnosed condition was causally related 

to factors of his employment. 

On July 22, 2014 appellant, through counsel, requested an oral telephone hearing. 

On November 26, 2014 Dr. Sergio Solorzano, a family medicine practitioner, completed 

a form entitled Rationalized Medical Opinion Form to establish Causal Relationship. He noted 

that appellant hurt his shoulder in 1998 and the pain went to his arms and hands, which worsened 

as the years passed. Dr. Solorzano diagnosed carpal tunnel syndrome and noted that appellant 

complained of tingling and numbness in the hands and wrist. The bottom of the page read: “In 

my medical opinion, the facts of injury are the direct and proximate cause of the diagnosis that I 

cited above. This is based on reasonable medical probability. There may be other causes for this 

medical problem, but one of the causes is clearly the activities of work described [by appellant] 

and described above”. 

On February 11, 2015 an oral telephone hearing took place. Appellant described his 

work duties which included blasting parts in a booth. He explained that he had to hold the 

nozzle with his right hand and the part with his left hand at either a 45- or 90-degree angle 

depending on the part. 

By decision dated March 17, 2015, an OWCP hearing representative set aside the 

July 17, 2014 decision and remanded the case for OWCP to refer appellant to a second opinion 

physician. The hearing representative found that Dr. Solorzano’s report was sufficient to warrant 

further development of the record. 

On May 26, 2015 OWCP referred appellant, together with the medical record and a 

statement of accepted facts, to Dr. Walter Del Gallo, a Board-certified orthopedic surgeon, for an 

opinion on whether appellant’s diagnosed conditions were causally related to factors of his 

employment. In a June 11, 2015 report, Dr. Del Gallo advised that appellant was employed as a 

sandblaster for 29 years and detailed his treatment history. He noted that appellant complained 

of left hand numbness and tingling and shoulder soreness despite overall improvement following 

a 2001 surgery. On examination Dr. Del Gallo noted full bilateral shoulder range of motion, 

mild-to-moderate thenar atrophy of both thumbs, positive Tinel’s and Phalen’s test worse on the 

left, negative Tinel’s test at the ulnar nerve at both elbows, no left knee effusion, full left knee 

range of motion, and mild left knee tenderness of the medial and lateral joint lines. He opined 

that appellant’s carpal tunnel syndrome was not caused or aggravated by factors of his federal 
4

employment. Dr. Del Gallo quoted the sixth edition of the American Medical Association,

Guides to Evaluation of Disease and Injury Causation (hereinafter A.M.A., Guides),3

 which in 

part stated that “carpal tunnel syndrome has an indistinct multi factorial etiology; often a single 

cause cannot be identified. [Dr. Del Gallo] indicated that the publication noted that there was 

inconsistent evidence regarding whether work factors caused carpal tunnel syndrome and very 

strong evidence that age was a contributing factor. He concluded based on this evidence that 

there was no data to support that appellant’s carpal tunnel syndrome was secondary to his work. 

[Dr. Del Gallo] opined that appellant’s carpal tunnel syndrome was age related as his condition 

worsened as he aged. He also concluded that appellant’s left shoulder and knee conditions were 

not work related as there were scant medical records related to these conditions. 

In a July 1, 2015 decision, OWCP denied appellant’s claim because the medical evidence 

of record was insufficient to establish that his diagnosed conditions were causally related to work 

factors. 

By letter dated July 8, 2015, appellant, through counsel, requested an oral telephone 

hearing. 

Appellant provided medical reports documenting his treatment since 2001. In a 

November 2, 2001 report, Dr. Robert Lewis, a Board-certified orthopedic surgeon, advised that 

appellant injured his left shoulder two years prior at work when he tried to catch a large 

transmission that was tipping over. He noted that appellant reinjured his shoulder on October 16, 

2000 when a door hit his left shoulder. January 6 and May 23, 2001 and January 14 and May 1, 

2002 disability status reports from Dr. Lewis diagnosed left shoulder impingement syndrome and 

restricted appellant’s lifting to 20 pounds with no overhead use of the left arm. In a 

September 23, 2003 report, Dr. Lewis advised that appellant had a work-related left shoulder 

condition, which required surgery in January 2001. He noted that appellant was able to return to 

work, but still experienced residual symptoms. Several physical therapy reports were submitted. 

On February 10, 2016 an oral telephone hearing took place. Counsel argued that there 

was a medical conflict and asserted that Dr. Del Gallo had his mind set that carpal tunnel 

syndrome could never be work related. He also argued that 95 percent of Dr. Del Gallo’s 

opinion on causal relationship was quoted from the A.M.A., Guides publication. 

By decision dated April 26, 2016, an OWCP hearing representative affirmed the July 1, 

2015 decision. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA has the burden 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, that an injury was sustained in the performance of duty as alleged and that any 

disabilities and/or specific conditions for which compensation is claimed are causally related to 

 3

 A.M.A., Guides (2nd ed. 2013). 
5

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

Whether an employee actually sustained an injury in the performance of duty begins with 

an analysis of whether fact of injury has been established. To establish an occupational disease 

claim, 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

 

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

causal relationship is rationalized medical opinion evidence. Rationalized medical opinion 

evidence is generally required to establish causal relationship. The opinion of the physician must 

be based on a complete factual and medical background, 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.7

 

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 

The Board finds that the case is not in posture for decision. 

OWCP referred appellant for a second opinion examination with Dr. Del Gallo. In his 

May 26, 2015 report, Dr. Del Gallo opined that appellant’s carpal tunnel syndrome was not 

caused or aggravated by factors of his federal employment. He quoted the second edition of the 

A.M.A., Guides, which in part specified that “carpal tunnel syndrome has an indistinct multi 

factorial etiology; often a single cause cannot be identified.” Dr. Del Gallo indicated that the 

publication noted that there was inconsistent evidence regarding whether work factors caused 

carpal tunnel syndrome and very strong evidence that age was a contributing factor. He 

concluded based on this that there was no data to support that appellant’s carpal tunnel syndrome 

was secondary to his work. Dr. Del Gallo opined that appellant’s carpal tunnel syndrome was 

age related as his condition worsened as he got older. He also concluded that appellant’s left 

shoulder and knee conditions were not work related as there was scant medical evidence 

regarding these conditions. OWCP determined that Dr. Del Gallo’s report represented the 

weight of the medical evidence. 

 4 Elaine Pendleton, 40 ECAB 1143 (1989). 

5 Victor J. Woodhams, 41 ECAB 345 (1989). 

6 R.H., 59 ECAB 382 (2008); Ernest St. Pierre, 51 ECAB 623 (2000). 

7 I.J., 59 ECAB 408 (2008); supra note 5. 

8

 James Mack, 43 ECAB 321 (1991). 
6

Although Dr. Del Gallo noted that the A.M.A., Guides publication specifies that there is 

insufficient evidence to support that certain work factors cause carpal tunnel syndrome, the 

Board has held that newspaper clippings, medical texts, and excerpts from publications are of no 

evidentiary value in establishing the causal relationship between a claimed condition and an 

employee’s federal employment. Such materials are of general application and are not 

determinative as to whether the specific condition claimed is related to the particular 

employment factors alleged by the employee.9

 The Board finds that Dr. Del Gallo’s medical 

opinion is not sufficiently rationalized. Dr. Del Gallo explained that there was no evidence to 

support that appellant’s carpal tunnel syndrome was secondary to his work and opined that it was 

age related because it worsened as he aged. However, he failed to discuss appellant’s specific 

work duties and simply relied on the general principle found in a publication. 

As Dr. Del Gallo’s opinion is not sufficiently rationalized, appellant must be referred to 

another Board-certified specialist. It is well established that proceedings under FECA are not 

adversarial in nature and, while the claimant has the burden to establish entitlement to 

compensation, OWCP shares responsibility in the development of the evidence.10 Once OWCP 

undertakes development of the medical evidence, it has the responsibility to do so in a proper 

manner.

11

CONCLUSION 

The Board finds that this case is not in posture for decision. 

 9 William C. Bush, 40 ECAB 1064, 1075 (1989). 

10 Richard E. Simpson, 55 ECAB 490 (2004). 

11 Melvin James, 55 ECAB 406 (2004). 
7

ORDER 

IT IS HEREBY ORDERED THAT the April 26, 2016 decision of the Office of 

Workers’ Compensation Programs is set aside and the case is remanded for further action 

consistent with this decision. 

Issued: December 27, 2016 

Washington, DC 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board