United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

D.S., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Troy, MI, Employer

__________________________________________

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Docket No. 19-0925

Issued: September 25, 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 March 27, 2019 appellant, though counsel, filed a timely appeal from a March 8, 2019 

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 has met her burden of proof to establish a medical condition 

causally related to the accepted factors of her federal employment.

FACTUAL HISTORY

On June 15, 2015 appellant, then a 57-year-old customer care agent,3filed an occupational 

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

factors of her federal employment. She alleged that her work duties increased and thereby caused 

increased symptoms. Appellant asserted that she first became aware of her claimed condition on 

February 7, 2000 and first realized its relation to her federal employment on March 28, 2015. She

stopped work on March 17, 2015.4

Appellant submitted several medical reports in support of her claim, including a June 4, 

2015 report from Dr. Sophia Grias-Radwanski, a Board-certified physical medicine and 

rehabilitation physician. Dr. Grias-Radwanski diagnosed moderate bilateral carpal tunnel 

syndrome, bilateral cubital tunnel syndrome, and neck pain with radiculopathy symptoms (as 

reported by appellant, but not seen on diagnostic testing). 

In a July 23, 2015 development letter, OWCP requested that appellant submit additional 

factual and medical evidence in support of her occupational disease claim, including a description 

of the work duties which she believed caused or aggravated her medical condition. In response, 

appellant submitted a statement in which she described her work duties, including the typing and 

mouse usage required by her job as a customer care agent. She asserted that her use of a headset 

placed pressure on her neck and shoulders, and she claimed that her work caused injury to her 

upper extremities, neck, and shoulders.5 Appellant also submitted additional reports of Dr. GriasRadwanski and other attending physicians.

By decision dated September 24, 2015, OWCP denied appellant’s present occupational 

disease claim because she had not established the factual component of fact of injury. It concluded, 

therefore, that the requirements had not been met to establish an injury as defined by FECA. 

 

3 Appellant had worked on a full-time basis as a customer care agent since January 19, 2013. Her work duties 

included typing on a computer keyboard and using a computer mouse in order to address customer inquiries. Appellant

was required to engage in intermittent hand and wrist movements and she had the option to sit or stand as tolerated.

4 The present claim was assigned OWCP File No. xxxxxx503. Appellant has a prior claim under OWCP File No. 

xxxxxx427, for which she filed an occupational disease claim (Form CA-2) in January 2003. In March 2003 OWCP 

accepted the claim for bilateral carpal tunnel syndrome. Appellant filed a notice of recurrence (Form CA-2a) in 

October 2008 alleging a recurrence of disability due to the accepted bilateral carpal tunnel syndrome condition. 

OWCP converted appellant’s recurrence claim to a claim for a new occupational injury, assigned OWCP File No. 

xxxxxx340 and, in May 2009, it accepted that claim for aggravation of bilateral carpal tunnel syndrome. It has 

administratively combined OWCP File Nos. xxxxxx427, xxxxxx340, and xxxxxx503, with OWCP File No. 

xxxxxx427 designated as the master file. 

5 Appellant asserted that the job she performed prior to working as a customer care agent required her to periodically 

take her headset off and then put it back on.
3

On October 21, 2015 appellant requested a review of the written record by a representative 

of OWCP’s Branch of Hearings and Review. By decision dated February 2, 2016, OWCP’s 

hearing representative set aside OWCP’s September 24, 2015 decision and remanded the case to 

OWCP for further development of the evidence, to be followed by issuance of a de novo decision.

6

On remand, OWCP referred appellant for a second opinion examination with Dr. Allen L. 

Babcock, a Board-certified orthopedic surgeon. It requested that he provide an opinion regarding 

whether appellant sustained a new occupational injury. In a May 11, 2016 report, Dr. Babcock 

indicated that appellant might have bilateral carpal tunnel syndrome and he indicated that he could 

not identify an aspect of appellant’s work duties which would have caused or aggravated a medical 

condition. He advised that appellant could work as a telephone operator.

In July 25 and 27, 2016 reports, Dr. Grias-Radwanski diagnosed moderate bilateral carpal 

tunnel syndrome, bilateral cubital tunnel syndrome, bilateral ulnar neuropathy, myofascial neck 

pain with cervical disc herniation, and rotator cuff tendinitis/tear of the left shoulder. In her 

July 27, 2016 report, she opined that these medical conditions were caused or aggravated by

appellant’s employment activities.

In a September 28, 2016 memorandum, OWCP advised that it had found a conflict in the 

medical opinion evidence between Dr. Grias-Radwanski and Dr. Babcock regarding whether 

appellant sustained a new occupational injury due to employment factors. It referred appellant for 

an impartial medical examination with Dr. Joseph Salama, a Board-certified orthopedic surgeon. 

OWCP requested that Dr. Salama provide an opinion regarding whether appellant sustained a new 

occupational injury. 

In an October 31, 2016 report, Dr. Salama noted that appellant had significant arthritis in 

her cervical spine which was the result of a natural degenerative process and was not causally 

related to her work.

7

 He advised that he was unable to say with any certainty if there was a causal 

relationship between appellant’s employment and her bilateral carpal tunnel syndrome or left 

cubital tunnel syndrome. Dr. Salama also noted, “I do however believe that her employment may 

have aggravated these conditions.” On February 16, 2017 he advised OWCP that he had reviewed 

additional medical records, but noted that these records did not change his October 31, 2016 

opinion.8

 

6 The hearing representative acknowledged that appellant had submitted a detailed statement describing her work 

duties.

7 Dr. Salama also noted that electromyogram and nerve conduction velocity (EMG/NCV) testing showed that 

appellant had bilateral carpal tunnel syndrome as well as left cubital tunnel syndrome without evidence of active 

denervation in the thenar muscle group or ulnar-inverted hand/forearm muscles.

8 On November 11, 2016 OWCP requested a supplemental report from Dr. Babcock. In a November 23, 2016 

report, Dr. Babcock noted that appellant had not worked since March 17, 2015 and he maintained that she had not 

suffered an employment-related aggravation of her medical condition. He believed that appellant could work on a 

full-time basis as a telephone operator with occasional use of a keyboard and mouse. It is unclear from the case record 

why OWCP requested a supplemental report from Dr. Babcock after declaring a conflict in the medical opinion 

evidence.
4

On March 10, 2017 OWCP requested that Dr. Salama provide a supplemental report which 

included a definitive opinion as to whether appellant’s upper extremity conditions were aggravated 

by her employment activities. Dr. Salama did not provide a supplemental report and OWCP 

referred appellant for new impartial medical examination with Dr. Scott T. Monson, a Boardcertified orthopedic surgeon. OWCP requested that Dr. Monson provide an opinion regarding 

whether appellant sustained a new occupational injury.

In an October 30, 2017 report, Dr. Monson noted that his examination revealed that 

appellant appeared to have mild bilateral carpal tunnel syndrome from a clinical standpoint. He 

noted that her carpal tunnel condition continued even though she had not worked in over two years

and he opined that the condition was “likely not work related in this instance.” Dr. Monson 

indicated that appellant could work as a customer care agent.

By decision dated November 20, 2017, OWCP denied appellant’s claim, noting that the 

special weight of the medical opinion evidence rested with the well-rationalized opinion of

Dr. Monson.

On November 28, 2017 appellant, through counsel, requested a telephonic hearing with a 

representative of OWCP’s Branch of Hearings and Review. Prior to the hearing being held, 

OWCP’s hearing representative issued a decision on April 20, 2018 by which she set aside the 

November 20, 2017 decision and remanded the case to OWCP for additional development, to be 

followed by issuance of a de novo decision. She indicated that a request should be made for

Dr. Monson to provide a supplemental report.

Dr. Monson did not provide a supplemental report and, in June 2018, OWCP referred 

appellant for an impartial medical examination to Dr. Clifford M. Buchman, a Board-certified 

orthopedic surgeon. OWCP requested that Dr. Buchman provide an opinion regarding whether 

appellant had carpal tunnel syndrome, ulnar neuropathy, myofascial neck pain with cervical disc 

herniation, or rotator cuff tendinitis tear of the left shoulder. It further requested that, if appellant 

had any of these conditions, Dr. Buchman should indicate whether they were caused or aggravated 

by employment factors. 

In a July 28, 2018 report, Dr. Buchman discussed appellant’s factual and medical history, 

including her work as a customer care agent from January 2013 to March 2015. He reported the 

findings of his physical examination, noting that there was no atrophy in appellant’s upper 

extremities and that the results were negative for Phalen’s, Tinel’s, Finkelstein’s, and Allen’s tests. 

Dr. Buchman reported good upper extremity strength with normal sensation to pinprick.9 He 

reported findings upon range of motion testing of the cervical spine and noted that the Spurling’s 

test was negative. With respect to the shoulders, Dr. Buchman noted that impingement was 

negative and that strength in the relevant muscle groups was excellent. He diagnosed negative 

examination for carpal tunnel syndrome, ulnar neuropathy, cervical spine, and shoulder rotator 

cuff tear. Dr. Buchman also noted that the upper extremity examination revealed no clinical signs 

of cubital tunnel syndrome and that the shoulder examination showed no evidence of pathology. 

 

9 Dr. Buchman noted that appellant exhibited weakness upon grip testing, but he opined that the test results had 

questionable validity.
5

Upon the cervical examination, appellant had full range of motion of the cervical spine and did not 

exhibited any pain or spasm. 

Dr. Buchman advised that the examination of appellant’s shoulders was negative, noting 

that she might have symptoms in her shoulders, but did not have clinical findings. He indicated 

that an April 2016 magnetic resonance imaging (MRI) scan of appellant’s left shoulder was 

positive for a very small tear of the supraspinatus tendon and that a June 2015 MRI scan of her 

cervical spine showed some degenerative changes which were normal with aging. Dr. Buchman 

indicated that June 2015 EMG/NCV findings were negative for appellant’s hands, although she 

previously had mildly positive EMG/NCV findings. He maintained that appellant’s use of 

headsets would not have been a factor in causing any of her symptom complexes. Dr. Buchman 

advised that appellant’s clinical findings during the July 28, 2018 examination were negative and 

opined that none of her employment activities would have caused or aggravated her carpal tunnel, 

cubital tunnel, neck, or shoulder complaints/conditions. 

By decision dated August 23, 2018, OWCP denied appellant’s claim, finding that the 

special weight of the medical opinion evidence rested with the well-rationalized opinion of

Dr. Buchanan, the impartial medical specialist.

On August 29, 2018 appellant, through counsel, requested a telephonic hearing with a 

representative of OWCP’s Branch of Hearings and Review. During the hearing held on January 9, 

2019, appellant provided further details regarding the repetitive work duties, including typing and 

handling her headset, which she believed caused her to develop several medical conditions.

By decision dated March 8, 2019, OWCP’s hearing representative affirmed OWCP’s 

August 23, 2018 decision. 

LEGAL PRECEDENT

An employee seeking benefits under FECA10 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,11 that 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.12 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.13

 

10 Supra note 2.

11 S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59 ECAB 178 (2007); Joe D. Cameron, 41 ECAB 

153 (1989).

12 J.M., Docket No. 17-0284 (issued February 7, 2018); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40 

ECAB 312 (1988).

13 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

To establish that an injury was sustained in the performance of duty in an occupational 

disease claim, a claimant must submit the following: (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 identified employment factors.14

The medical evidence required to establish causal relationship is rationalized medical 

opinion evidence.15 The opinion of the physician must be based on a complete factual and medical 

background of the employee, 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 established employment factors.16

Section 8123(a) of FECA provides in pertinent part: “If there is disagreement between the 

physician making the examination for the United States and the physician of the employee, the 

Secretary shall appoint a third physician who shall make an examination.”

17

 In situations where 

there exist opposing medical reports of virtually equal weight and rationale and the case is referred 

to an impartial medical specialist for the purpose of resolving the conflict, the opinion of such 

specialist, if sufficiently well rationalized and based upon a proper factual background, must be 

given special weight.18

ANALYSIS

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

condition causally related to the accepted factors of her federal employment.

OWCP properly determined that there was a conflict in the medical opinion evidence 

between Dr. Grias-Radwanski, an attending physician, and Dr. Babcock, an OWCP referral 

physician, on the issue of whether appellant sustained a medical condition causally related to her 

accepted employment factors. In order to resolve the conflict, OWCP properly referred appellant, 

pursuant to section 8123(a) of FECA, to Dr. Buchman, a Board-certified orthopedic surgeon, for 

an impartial medical examination and an opinion on the matter.19

 

14 E.V., Docket No. 18-1617 (issued February 26, 2019); Victor J. Woodhams, 41 ECAB 345, 352 (1989).

15 F.S., Docket No. 15-1052 (issued July 17, 2015); Tomas Martinez, 54 ECAB 623 (2003).

16 P.K., Docket No. 08-2551 (issued June 2, 2009); John W. Montoya, 54 ECAB 306 (2003).

17 5 U.S.C. § 8123(a).

18 D.M., Docket No. 18-0746 (issued November 26, 2018); R.H., 59 ECAB 382 (2008); James P. Roberts, 31 ECAB 

1010 (1980).

19 See supra note 16. OWCP had referred appellant for prior impartial medical examinations, first to Dr. Salama 

and later to Dr. Monson. However, the impartial medical specialists failed to provide supplemental reports explaining 

their initial reports and, therefore, it was appropriate for OWCP to refer appellant to Dr. Buchman. See generally S.R.,

Docket No. 17-1118 (issued April 5, 2018); Nancy Lackner (Jack D. Lackner), 40 ECAB 232, 238 (1988) (regarding 

OWCP’s duty to obtain supplemental reports from impartial medical specialists when necessary for clarification).
7

In a July 28, 2018 report, Dr. Buchman noted that appellant’s upper extremities were 

negative for Phalen’s, Tinel’s, Finkelstein’s, and Allen’s tests and that she had good upper 

extremity strength with normal sensation to pinprick. He noted that range of motion of the cervical 

spine was normal and that strength in the muscle groups of the shoulders was excellent.

Dr. Buchman diagnosed negative examination for carpal tunnel syndrome, ulnar neuropathy, 

cervical spine, and shoulder rotator cuff tear, and he also noted that the upper extremity 

examination revealed no clinical signs of cubital tunnel syndrome. He indicated that appellant’s 

June 2015 MRI scan cervical spine scan showed some degenerative changes which were normal 

with aging and that her June 2015 EMG/NCV testing was negative for upper extremity findings. 

Dr. Buchman concluded that her clinical findings during the July 28, 2018 examination were 

negative and he opined that none of her employment activities would have caused or aggravated 

her ostensible carpal tunnel, cubital tunnel, neck, or shoulder conditions.20

The Board finds that the special weight of the medical evidence is represented by the 

thorough, well-rationalized opinion of Dr. Buchman, the impartial medical specialist selected to 

resolve the conflict in the medical opinion.21 Dr. Buchman’s July 25, 2018 report establishes that 

appellant did not sustain a medical condition causally related to her accepted employment factors. 

The Board has carefully reviewed the opinion of Dr. Buchman and notes that it has reliability, 

probative value, and convincing quality with respect to its conclusions regarding the relevant issue 

of the present case. Dr. Buchman provided a thorough factual and medical history and accurately 

summarized the relevant medical evidence. He provided medical rationale for his opinion by 

explaining that appellant’s clinical findings during the July 28, 2018 examination were negative. 

Dr. Buchman further explained that appellant’s employment activities would not have been 

competent to cause or aggravate her claimed upper extremity, neck, or shoulder conditions.

22

As the evidence of record is insufficient to overcome the special weight accorded to

Dr. Buchman, the Board finds that appellant has not met her burden of proof.

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 her burden of proof to establish a medical 

condition causally related to the accepted factors of her federal employment.

 

20 In particular, Dr. Buchman indicated that appellant’s use of headsets would not have been a factor in causing any 

of her symptom complexes.

21 See supra note 17.

22 See W.C., Docket No. 18-1386 (issued January 22, 2019); Melvina Jackson, 38 ECAB 443 (1987) (regarding the 

importance, when assessing medical evidence, of such factors as a physician’s knowledge of the facts and medical 

history, and the care of analysis manifested and the medical rationale expressed in support of the physician’s opinion).
8

ORDER

IT IS HEREBY ORDERED THAT the March 8, 2019 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: September 25, 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