United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

N.B., Appellant

and

DEPARTMENT OF VETERANS AFFAIRS, 

OLIN E. TEAGUE VETERANS CENTER, 

Temple, TX, Employer

__________________________________________

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Docket No. 19-0079

Issued: June 14, 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 October 15, 2018 appellant filed a timely appeal from a May 7, 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 to 

consider the merits of this case.2

ISSUE

The issue is whether appellant has met her burden of proof to establish that her diagnosed 

dermatitis is causally related to accepted factors of her federal employment.

 

1 5 U.S.C. § 8101 et seq.

2 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

FACTUAL HISTORY

On January 24, 2018 appellant, then a 45-year-old surgical technician, filed an 

occupational disease claim (Form CA-2) alleging that she developed contact dermatitis due to 

exposure to substances while in the performance of her federal employment duties. She noted that 

both hands itched and that her skin was painful with open sores. Appellant indicated that she first 

became aware of her disease or illness and of its relation to her federal employment duties on 

December 5, 2017. She did not stop work.

In a development letter dated February 12, 2018, OWCP informed appellant of the 

deficiencies of her occupational disease claim. It advised her of the type of factual and medical 

evidence needed and provided a questionnaire for her completion. In a separate letter of even date, 

OWCP requested comments from the employing establishment regarding substances to which 

appellant had been exposed while at work. Both parties were afforded 30 days to submit additional 

evidence.

A February 8, 2018 duty status report (Form-CA-17) provided work restrictions precluding 

use of appellant’s right hand and right wrist.

By decision dated April 11, 2018, OWCP denied appellant’s claim, finding that the medical 

evidence of record was insufficient to establish a diagnosed condition in connection with the 

accepted factors of her federal employment.

On April 27, 2018 appellant requested reconsideration. 

In a December 5, 2017 note, Dr. David F. Butler, a Board-certified dermatologist, noted 

that appellant, a scrub technician, had an itchy rash on her hands. He noted that at work she used 

betadine and antiseptic cleanser throughout the day. On January 9 and 22, 2018 Dr. Butler 

diagnosed eczematous dermatitis on the dorsum of both hands with no specific aggravation or 

triggering factor.

On January 26, 2018 Dr. Lisa Shirley-Williams, a Board-certified dermatologist, found 

that appellant’s chronic hand dermatitis was due to an allergic reaction to p-Phenylenediamine 

(PPDA) or hair dye. She recommended the use of latex-free gloves, hand moisturizer, and 

medicated ointment. On February 5, 2018 Dr. Butler attributed appellant’s hand dermatitis to an 

exacerbation with scrubbing and possible recent triggering event of dyeing her hair in 

November 2017.

In a February 26, 2018 report, Dr. Butler described appellant’s job requirements of 

scrubbing her hands and wrists with antiseptics several times a day. He noted that she believed 

that this duty was causing or aggravating the rash on her hands. Dr. Butler found hyperpigmented 

scaly eczematous patches on the dorsum of both hands and wrists. He recommended avoidance 

of scrubbing as well as application of ointment and application of moisturizing ointment. 

Dr. Butler noted that appellant first reported her itchy rash on her hands and chest on 

August 7, 2017. On January 9, 2018 appellant returned for treatment because of an acute 

exacerbation following return to work after a vacation. She noted that while on vacation her rash 

had cleared completely, but that after she returned to work and to scrubbing her hands, an eruption 

quickly returned. Dr. Butler reviewed appellant’s allergy testing and concluded that her PPDA or 
3

hair dye allergy was not applicable in playing a direct role in her hand dermatitis. He found 

appellant had severe irritant dermatitis of the hands and wrists caused or aggravated by scrubbing 

her hands with antiseptics as part of her employment as an operating room technician. Dr. Butler 

concluded that the act of scrubbing with antiseptics on a daily basis as required for her job had 

definitely caused or made manifest irritant eczematous dermatitis. He determined that appellant 

could not scrub her hands at work and should perform light-duty work.

By decision dated May 7, 2018, OWCP modified the April 11, 2018 decision to reflect that 

appellant had established a diagnosed medical condition. However, the claim remained denied as 

the medical evidence of record was not sufficiently rationalized to establish causal relationship 

between the accepted factors of her federal employment and her diagnosed conditions.

LEGAL PRECEDENT

An employee seeking benefits under FECA 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 

OWCP’s regulations define an occupational disease as “a condition produced by the work 

environment over a period longer than a single workday or shift.”

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 identified 

employment factors. 

Causal relationship is a medical question, which requires rationalized medical opinion 

evidence to resolve the issue.7 A physician’s opinion on whether there is causal relationship 

between the diagnosed condition and the implicated employment factors must be based upon a 

complete factual and medical background.8 Additionally, his or her opinion must be expressed in 

 

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

153 (1989).

4

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 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 20 C.F.R. § 10.5(q).

7 E.V., Docket No. 18-1617 (issued February 26, 2019).

8

Id.
4

terms of a reasonable degree of medical certainly, and must be supported by medical rationale, 

explaining the nature of the relationship between the diagnosed condition and the claimant’s 

specific employment factors.9 The belief of a claimant that a condition was caused or aggravated 

by the employment is not sufficient to establish causal relation.10

ANALYSIS

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

diagnosed dermatitis is causally related to the accepted factors of her federal employment.

On January 26, 2018 Dr. Shirley-Williams diagnosed chronic hand dermatitis. She 

attributed appellant’s condition to an allergic reaction to PPDA or hair dye. Dr. Shirley-Williams 

did not attribute appellant’s dermatitis to her employment. In a series of notes dated December 5,

2017, and January 9 and 22, 2018, Dr. Butler diagnosed eczematous dermatitis on the dorsum of 

both hands with no specific aggravation or triggering factor. On February 5, 2018 he attributed 

appellant’s hand dermatitis to a possible recent triggering event of dyeing her hair in 

November 2017. These reports did not attribute appellant’s dermatitis to her accepted employment 

exposures or duties. Instead both Drs. Butler and Shirley-Williams indicated that appellant’s 

dermatitis was either idiopathic or due to an allergy to hair dye. As these reports did not attribute 

the diagnosed condition to appellant’s employment, they have no probative value on the issue of 

causal relationship and are insufficient to meet appellant’s burden of proof in her occupational

disease claim.11

On February 26, 2018 Dr. Butler reviewed appellant’s allergy testing and concluded that 

her PPDA or hair dye allergy was not playing a direct role in her hand dermatitis. He found that 

she had severe irritant dermatitis of the hands and wrists caused or aggravated by scrubbing her 

hands with antiseptics as part of her employment as an operating room technician. Dr. Butler 

concluded that the act of scrubbing with antiseptics on a daily basis as required for appellant’s job 

had definitely caused or made manifest irritant eczematous dermatitis. While Dr. Butler opined 

that appellant’s job duties caused or contributed to her diagnosed dermatitis, he did not offer 

medical rationale explaining how the accepted job duty caused the diagnosed condition.12 He did 

not explain how the mechanism of injury would have physiologically caused the diagnosed 

condition.13 Thus, Dr. Butler’s reports are insufficient to establish appellant’s burden of proof.

The fact that a condition manifests itself during a period of employment is insufficient to 

establish causal relationship. Temporal relationship alone will not suffice. Entitlement to FECA 

benefits may not be based on surmise, conjecture, speculation, or on the employee’s own belief of 

a causal relationship.14 The Board finds that the record lacks rationalized medical evidence 

 

9

Id.; Victor J. Woodhams, 41 ECAB 345, 352 (1989).

10 Lourdes Harris, 45 ECAB 545, 547 (1994).

11 T.H., Docket No. 18-1736 (issued March 13, 2019).

12 Id.

13 Id.

14 Id.; D.D., 57 ECAB 734 (2006).
5

establishing causal relationship between the implicated job duties and her diagnosed dermatitis.15 

Thus, 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 that her 

diagnosed dermatitis is causally related to the accepted factors of her federal employment.

ORDER

IT IS HEREBY ORDERED THAT the May 7, 2018 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: June 14, 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

 

15 Id.; J.S., Docket No. 17-0507 (issued August 11, 2017).