United States Department of Labor

Employees’ Compensation Appeals Board

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T.S., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Muskegon, MI, Employer

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Docket No. 18-1518

Issued: April 17, 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

ALEC J. KOROMILAS, Alternate Judge

JURISDICTION

On August 3, 2018 appellant filed a timely appeal from March 30 and July 30, 2018 merit 

decisions 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.2

 

1 5 U.S.C. § 8101 et seq.

2 The Board notes that, following the July 30, 2018 decision, OWCP received additional evidence. 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 his burden of proof to establish that his right carpal 

tunnel syndrome and left ulnar nerve neuropathy were causally related to the accepted factors of 

his federal employment. 

FACTUAL HISTORY

On June 20, 2017 appellant, then a 76-year-old retired city carrier, filed an occupational 

disease claim (Form CA-2) alleging that he developed latent carpal tunnel syndrome and ulnar 

nerve damage due to sorting and delivering mail for many years.3 He noted that his previous job

duties required holding his left elbow at 90 degrees, sliding mail with his left thumb, and constantly 

moving all joints of his right upper extremity during the workday. OWCP assigned the claim File 

No. xxxxxx468.4

In support of this claim, appellant submitted a December 14, 2015 report from Dr. Kate 

McCausland, an osteopathic Board-certified physiatrist, who reviewed a December 14, 2015 

electromyography and nerve conduction velocity (EMG/NCV) study of appellant’s upper

extremities. Dr. McCausland related that this study demonstrated right carpal tunnel syndrome, 

and left ulnar neuropathy at the elbow. 

In a report dated December 22, 2015, Dr. Yousif Hamati, a Board-certified orthopedic 

surgeon, reviewed the EMG/NCV findings and opined that they were secondary to a March 18, 

1991 injury. He also noted that appellant had been a mailman for 40 years and did significant 

amounts of mail sorting. Dr. Hamati concluded that any repetitive work for 40 years was definitely 

a major contributing factor to his symptoms and diagnoses. 

In a development letter dated June 28, 2017, OWCP advised appellant that the factual and 

medical evidence submitted was insufficient to establish his claim. It informed him of the type 

evidence needed and provided a questionnaire for his completion. OWCP afforded appellant 30 

days to submit the necessary evidence. 

In response, appellant submitted a statement in which he explained that he began work as 

a letter carrier on June 11, 1960 and retired November 2, 2002. He included a description of duties 

taken from a mail carrier handbook and described his daily work sorting and delivering mail. 

Appellant maintained that his 42 years of performing rigorous carrier duties of having a constant 

bent left elbow while firmly gripping a bundle of mail in the left hand, flexing and extending both

thumbs, and continually manipulating fingers on the right hand for up to 11.5 hours a day of 750 

 

3 Appellant retired from federal employment on November 2, 2002. 

4 Appellant has several prior claims. In File No. xxxxxx784 OWCP accepted a June 6, 1978 traumatic injury claim 

for left knee meniscus derangement and left leg arthropathy. In OWCP File No. xxxxxx938 OWCP accepted that, on 

March 18, 1991, he sustained bilateral shoulder strains, fractured left numerus, lumbar strain, and C6-7 herniated disc. 

In File No. xxxxxx096 OWCP accepted a December 18, 2000 traumatic injury claim for aggravation of right shoulder 

osteoarthritis and lumbar sprain and displacement of cervical intervertebral disc without myelopathy. OWCP has 

administratively combined File Nos. xxxxxx468, xxxxxx784, xxxxxx938, and xxxxxx096, with File No. xxxxxx096 

designated as the master file. 
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to 3000 pieces of mail had contributed to his left ulnar neuropathy and right carpal tunnel 

syndrome. 

Appellant also submitted duplicate copies of Dr. McCausland’s December 14, 2015 report

and Dr. Hamati’s December 22, 2015 treatment note. 

In an April 14, 2016 report, Dr. Hamati noted that appellant was concerned that there was 

no finding of cervical radiculopathy with axon loss on the EMG/NCV study and was certain that 

he had significant nerve damage to his neck. He indicated that he discussed the EMG/NCV

findings of right carpal tunnel syndrome and left ulnar nerve neuropathy and counseled appellant 

regarding the possibility of severe neck pain without severe axonal injuries. Dr. Hamati concluded 

that appellant became frustrated with this discussion and chose to end the conversation. In an 

August 18, 2016 treatment note, he indicated that appellant was very frustrated with all of his 

problems and was very particular about every word written in a report, for example whether he 

had mild or moderate carpal tunnel syndrome. Dr. Hamati reported that appellant continued to 

have difficulty with his neck and upper extremities, with tingling in both arms, noting that 

appellant felt that his neck injury was a major contributing factor to all his upper extremity 

symptoms, and that his job duties caused his carpal tunnel syndrome and ulnar neuropathy. 

In a January 26, 2017 report, Dr. Hamati reported that appellant continued to have 

significant difficulty with his right hand. He noted the EMG/NCV findings of right carpal tunnel 

syndrome and left ulnar nerve neuropathy, and reported appellant’s description of job duties. 

Dr. Hamati opined that literature documented that anyone who did repetitive work on a continuous 

basis for eight hours a day developed carpal tunnel syndrome and ulnar nerve neuropathy easily, 

due to the repetitive nature of the job. He reiterated that appellant had right hand carpal tunnel 

syndrome and left ulnar nerve neuropathy and “felt strongly” that the major contributing factor 

was appellant’s repetitive work. 

By decision dated September 20, 2017, OWCP denied appellant’s claim for right carpal 

tunnel syndrome and left ulnar neuropathy, finding that the claim had been untimely filed. 

On September 28, 2017 appellant requested reconsideration of the September 20, 2017 

decision. He asserted this his claim was timely filed because the carpal tunnel and ulnar injuries 

were latent. Appellant noted that he first became aware of his wrist conditions at the time of the 

EMG/NCV testing on December 12, 2015 and that he filed the claim less than one month later. 

By merit decision dated March 30, 2018, OWCP modified the September 20, 2018 

decision to find that appellant’s claim was timely filed. However, it denied the claim because the 

medical evidence submitted was insufficient to establish that the claimed right carpal tunnel 

syndrome and left ulnar neuropathy was causally related to his employment factors. 

Appellant requested reconsideration on May 7, 2018. He asserted that the medical 

evidence of record established that the claimed right carpal tunnel syndrome and left ulnar 

neuropathy were causally related to employment factors. Appellant submitted evidence previously 

of record including a statement dated September 2, 2011 and a February 6, 1992 EMG/NCV study 

of the upper extremities for a complaint of a numb left arm. The study was abnormal and 

demonstrated left C7 radiculopathy with no indication of carpal tunnel syndrome or brachial 
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plexopathy. Appellant further submitted a September 16, 2011 report in which Dr. March J. 

Moulton, a Board-certified orthopedic surgeon, noted a diagnosis of stenosis at C3-4 and C5-6 

levels. He recommended a discectomy. In a November 3, 2011 report, Dr. John F. Keller, a 

Board-certified neurosurgeon, diagnosed cervical radiculopathy and recommended surgery. 

In correspondence dated April 24 to June 4, 2018, appellant described his work duties and 

compensable injuries. He maintained that the repetitive duties of delivering mail for 30 years, plus 

his limited job from 1997 to 2002 caused carpal tunnel syndrome and ulnar nerve neuropathy.

By decision dated July 30, 2018, OWCP denied modification of its prior decision, finding 

that the evidence of record was of insufficient probative value to establish his claim. 

LEGAL PRECEDENT

An employee seeking benefits under FECA5 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 of FECA, that an injury was sustained in the performance of duty as alleged, and 

that any disability or specific condition for which compensation in claimed is causally related to 

the employment injury. 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.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 diagnosed 

condition is causally related to the employment factors identified by the claimant.7

To establish causal relationship between the claimed condition, as well as any attendant 

disability claimed and the employment event or incident, the employee must submit rationalized 

medical opinion evidence supporting such causal relationship.8 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. The weight of medical evidence is determined by its reliability, its probative value, 

 

5 Supra note 1.

6 D.J., Docket No. 18-0620 (issued October 10, 2018).

7 See C.M., Docket No. 17-1977 (issued January 29, 2019); Roy L. Humphrey, 57 ECAB 238 (2005).

8 M.C., Docket No. 18-0951 (issued January 7, 2019).
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its convincing quality, the care of analysis manifested, and the medical rationale expressed in 

support of the physician’s opinion.9

ANALYSIS

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

carpal tunnel syndrome and left ulnar nerve neuropathy were causally related to his accepted 

employment factors. 

Dr. Hamati submitted a series of reports beginning on December 22, 2015 in which he 

noted EMG/NCV findings and related that appellant’s repetitive duties as a letter carrier for over 

40 years were a major contributing factor to his symptoms and diagnoses. This opinion however 

is a mere conclusory opinion without the necessary rationale explaining how the employment 

factors were sufficient to result in the diagnosed medical conditions. The Board has found that 

such an opinion is insufficient to meet a claimant’s burden of proof to establish a claim.

10

In reports dated April 14, 2016 to April 24, 2018, Dr. Hamati noted that appellant 

continued to have difficulty with his neck and upper extremities. He opined that appellant’s 

repetitive job duties were a major factor in the diagnosed right carpal tunnel syndrome and left 

ulnar neuropathy, he added without mention a source that literature was full of papers which 

document that anyone who performed repetitive work on a continuous basis for eight hours a day 

easily developed carpal tunnel syndrome and ulnar nerve neuropath. As to Dr. Hamati’s reliance 

on medical publications, the Board has long held that excerpts from publications have little 

probative value in resolving medical questions unless a physician shows the applicability of the 

general medical principles discussed in the articles to the specific factual situation at issue in the 

case.11 He merely referenced the publications to support an opinion that repetitive duties cause 

carpal tunnel syndrome and ulnar neuropathy. Moreover, Dr. Hamati did not acknowledge that 

appellant had performed restricted duty from 1991 until he retired in 2002 or explain why these 

conditions had not developed until 2015. The Board therefore finds that Dr. Hamati’s statement 

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

this occupational disease claim, namely, how appellant’s actual employment duties, including his 

modified duties, would have caused or aggravated his subsequently diagnosed right carpal tunnel 

syndrome and left ulnar neuropathy conditions. Without explaining how, physiologically, the 

movements involved in appellant’s employment duties caused or contributed to his diagnosed 

conditions, Dr. Hamati’s opinion on causal relationship is equivocal in nature and his reports are 

of limited probative value.12

OWCP also received reports from Dr. Moulton and Dr. Keller. However, neither of these 

physicians discussed a cause of the diagnosed conditions. Medical evidence that does not offer an 

 

9 K.L., Docket No. 18-0937 (issued December 28, 2018).

10 J.R., Docket No. 18-0051 (issued March 23, 2018); J.D., Docket No. 14-2061 (issued February 27, 2015).

11 W.C. (R.C.), Docket No. 18-0531 (issued November 1, 2018); Roger D. Payne, 55 ECAB 535 (2004).

12 E.P., Docket No. 18-0194 (issued September 14, 2018); see L.M., Docket No. 14-0973 (issued August 25, 2014).
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opinion regarding the cause of an employee’s diagnosed condition is of no probative value on the 

issue of causal relationship.13

Similarly, while the record also includes diagnostic studies, the Board has held that 

diagnostic study reports lack probative value as they do not provide an opinion on causal 

relationship between appellant’s employment factors and a diagnosed condition.14

As the record is devoid of rationalized medical opinion evidence explaining how or why 

appellant’s employment duties either caused or contributed to the claimed conditions, he has not 

met his 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 his burden of proof to establish that his right 

carpal tunnel syndrome and left ulnar neuropathy conditions were causally related to his accepted 

employment factors. 

 

13 C.B., Docket No. 18-0663 (issued November 16, 2018). 

14 T.H., Docket No. 18-1736 (issued March 13, 2019); S.G., Docket No. 17-1054 (issued September 14, 2017).
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ORDER

IT IS HEREBY ORDERED THAT the July 30 and March 30, 2018 decisions of the 

Office of Workers’ Compensation Programs are affirmed.

Issued: April 17, 2019

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