United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

J.H., Appellant

and

DEPARTMENT OF JUSTICE, FEDERAL 

BUREAU OF PRISONS, FEDERAL 

CORRECTIONAL INSTITUTION-ASHLAND, 

Ashland, KY, Employer

__________________________________________

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Docket No. 19-0395

Issued: August 10, 2020

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

JANICE B. ASKIN, Judge

PATRICIA H. FITZGERALD, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On December 13, 2018 appellant, through counsel, filed a timely appeal from a

September 7, 2018 merit decision of the Office of Workers’ Compensation Programs (OWCP). 

 

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

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

ISSUE

The issue is whether appellant has met her burden of proof to establish more than two 

percent permanent impairment of her right upper extremity, for which she has previously received 

a schedule award. 

FACTUAL HISTORY

On September 13, 2013 appellant, then a 47-year-old drug treatment specialist, filed an 

occupational disease claim (Form CA-2) alleging that she developed right carpal tunnel syndrome 

due to factors of her federal employment which included inputting data on a computer. OWCP

accepted her claim for right carpal tunnel syndrome.

On June 20, 2013 appellant had undergone electromyogram and nerve conduction velocity 

(EMG/NCV) testing which contained an impression of moderately severe right carpal tunnel 

syndrome. 

Appellant received treatment for her right upper extremity condition from Dr. Laura Reese, 

an osteopath Board-certified in orthopedic surgery, who performed OWCP-authorized right carpal 

tunnel release surgery on January 15, 2014.

4

During a follow-up care visit on May 16, 2014, Dr. Reese advised that appellant reported 

that her right hand numbness and tingling were gone, but indicated that she experienced arthritictype pain in her right fingers which was not associated with the carpal tunnel. She noted physical 

examination findings of a well-healed right wrist incision without tenderness, and some crepitus 

at the right carpometacarpal joint. Appellant exhibited full range of motion of the right wrist upon 

flexion, extension, radial deviation, and ulnar deviation. Dr. Reese reported that sharp/dull 

sensation testing in the right median nerve distribution was normal and opined that appellant 

reached maximum medical improvement (MMI) from her carpal tunnel surgery. 

On August 25, 2014 appellant filed a claim for a schedule award (Form CA-7). 

In a September 22, 2014 letter, OWCP advised Dr. Reese that it had received her 

May 16, 2014 report, but that additional medical evidence was necessary to establish appellant’s 

 

2 5 U.S.C. § 8101 et seq.

3 The Board notes that following the September 7, 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.

4 Appellant stopped work on January 15, 2014 and returned to work on March 3, 2014. OWCP paid her wage-loss 

compensation on the supplemental rolls for disability from work.
3

schedule award claim. It requested that she submit a report which evaluated appellant’s permanent 

impairment pursuant to the sixth edition of the American Medical Association, Guides to the 

Evaluation of Permanent Impairment (A.M.A., Guides).5 OWCP afforded Dr. Reese 30 days to 

submit the requested evidence.

Dr. Reese did not submit evidence within the afforded period. However, on October 20, 

2014, OWCP received a September 26, 2014 report from Dr. Martin Fritzhand, a Board-certified

urologist, who advised that appellant reported that prolonged use of her right arm exacerbated her 

right hand pain. Appellant also reported diminished grip strength and sporadic numbness in her 

right hand, and she indicated that her right hand hurt when she had to repeatedly open doors at 

work. Dr. Fritzhand indicated that appellant reported it took longer for her to “complete things”

with her right hand at home and that she could not participate in her daughters’ basketball and 

softball activities. He noted that the physical examination revealed an equivocally positive right 

Tinel’s sign, diminished pinprick and light touch over the right thumb, well-preserved grip strength 

of the right hand, and no right upper extremity atrophy. Dr. Fritzhand opined that appellant 

reached MMI in May 2014. He provided a permanent impairment rating for the right upper 

extremity utilizing Table 15-23 (Entrapment/Compression Neuropathy Impairment) on page 449 

of the sixth edition of the A.M.A., Guides. Dr. Fritzhand determined that appellant’s condition 

fell under grade modifier 1 for test findings, grade modifier 2 for history, and grade modifier 2 for 

physical findings. He averaged these grade modifiers to 1.67, which he rounded up to 2, and he 

then noted that appellant fell under grade modifier 2 with a default impairment value of five percent 

for the right upper extremity. Dr. Fritzhand determined that, utilizing the functional scale portion 

of Table 15-23, appellant’s QuickDASH score of 68 required movement one space to the right of 

the default value. He therefore concluded that appellant had a total of six percent permanent 

impairment of the right upper extremity. 

By decision dated August 12, 2015, OWCP denied appellant’s claim for a schedule award

because the medical evidence did not establish permanent impairment to a scheduled member or 

function of the body.

On August 31, 2015 appellant, through counsel, requested a telephonic hearing before a 

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

OWCP’s hearing representative conducted a preliminary review and determined that the case was 

not in posture for decision. She issued a February 23, 2016 decision vacating the August 12, 2015 

decision and remanding the case to OWCP for further development. The hearing representative 

determined that OWCP failed to consider Dr. Fritzhand’s October 20, 2014 impairment rating 

report and directed OWCP, upon remand, to refer the report to an OWCP district medical adviser

(DMA) for review.

On February 29, 2016 OWCP referred the case record, including Dr. Fritzhand’s

October 20, 2014 report, to Dr. Morley Slutsky, a Board-certified occupational medicine physician 

serving as a DMA. It requested that the DMA provide an opinion on permanent impairment under 

the sixth edition of the A.M.A., Guides. In a March 6, 2016 report, the DMA advised that he 

needed the most recent EMG/NCV study to determine whether appellant met the criteria for the 

 

5 A.M.A., Guides (6th ed. 2009). 
4

diagnosis of right carpal tunnel syndrome. He also requested a copy of the statement of accepted 

facts (SOAF).

On May 13, 2016 OWCP routed the June 20, 2013 EMG/NCV study, the SOAF, and rest 

of the case file to the DMA, for review and an opinion on permanent impairment in accordance 

with the A.M.A., Guides. On May 22, 2016 the DMA reported that appellant reached MMI on 

May 16, 2014, the date of Dr. Reese’s examination and discussed his disagreement with

Dr. Fritzhand’s impairment rating. Utilizing Table 15-23 of the sixth edition of the A.M.A., 

Guides, the DMA determined that the June 20, 2013 EMG/NCV study showed that appellant fell 

under grade modifier 1 for test findings because the study met the criteria for right carpal tunnel 

syndrome and demonstrated sensory and motor conduction delays associated with the median 

nerve. He assigned a grade modifier 1 for history given that appellant had mild intermittent 

symptoms (without evidence that she was unable to perform at least one activity of daily living or 

that someone consistently did an activity of daily living for her). The DMA assigned a grade 

modifier of 1 for physical findings. He noted that Dr. Fritzhand found diminished pinprick and

light touch in the right medial nerve distribution, but did not perform appropriate two-point 

discrimination testing.

6

 Averaging the three grade modifiers meant that appellant fell under grade 

modifier 1 on Table 15-23 with a default impairment value of two percent. The DMA determined

that appellant’s QuickDASH score of 68 was invalid. He explained the A.M.A., Guides provides 

that, when the QuickDASH score exceeds 60 in the context of mild physical findings, there may 

be other diagnoses being overlooked which impact the subject’s answers and, therefore, the score 

is considered to be invalid. The DMA concluded that appellant’s condition did not warrant 

movement from the default impairment value of two percent and, therefore, the total permanent 

impairment of appellant’s right upper extremity was two percent.

By decision dated June 23, 2016, OWCP granted appellant a schedule award for two

percent permanent impairment of the right upper extremity (right arm). The award ran for 6.24 

weeks from July 25 to September 6, 2014 and was based on the May 22, 2016 impairment rating 

of the DMA.

On June 30, 2016 appellant, through counsel, requested a telephonic hearing before a

representative of OWCP’s Branch of Hearings and Review. Counsel submitted an August 20, 

2016 report from Dr. Fritzhand who noted that the DMA downgraded his assessment of appellant’s 

history from grade modifier 2 to grade modifier 1. Dr. Fritzhand argued that appellant had 

significant intermittent symptoms in her right upper extremity which Table 15-23 identified as 

defining grade modifier 2 for history. He noted that he used a discriminator wheel (two-point 

wheel) during his examination and indicated that his statement that pinprick and light touch were 

diminished implied greater than six millimeter discrimination, a finding which met the definition

of grade modifier 2. Dr. Fritzhand opined that appellant had six percent permanent impairment of 

the right upper extremity.

Prior to a hearing being held, OWCP’s hearing representative conducted a preliminary 

review and issued a November 16, 2016 decision vacating the June 23, 2016 decision and 

remanding the case to OWCP for further development. The hearing representative determined that

 

6 The DMA also indicated that appellant had no atrophy or muscle loss associated with the right median nerve.
5

Dr. Fritzhand’s August 20, 2016 report warranted further development, including referral of the 

report to a DMA for review.

On December 2, 2016 OWCP routed Dr. Fritzhand’s August 20, 2016 report to the DMA 

for review and evaluation of appellant’s permanent impairment. In a December 10, 2016 report,

the DMA confirmed his rating of two percent permanent impairment of the right upper extremity. 

Utilizing Table 15-23 of the sixth edition of the A.M.A., Guides, he determined that the June 20, 

2013 EMG/NCV study showed that appellant fell under grade modifier 1 for test findings because 

the study met the criteria for right carpal tunnel syndrome and demonstrated sensory and motor 

conduction delays associated with the right median nerve. The DMA assigned a grade modifier 1 

for history, noting that appellant’s right upper extremity symptoms were not constant, she could 

perform all of her activities of daily living despite her symptoms, and there was no mention that 

she required someone else to consistently perform an activity of daily living for her. He referenced 

the standards for evaluating the grade modifier for history found on page 433 of the A.M.A., 

Guides, and noted that a further reason that appellant did not qualify for grade modifier 2 or higher 

was that her right median nerve entrapment was not severe enough to make failure to function in 

a specific activity of daily living “believable.”

The DMA further determined that appellant fell under a grade modifier of 1 for physical 

findings, noting that the A.M.A., Guides provides on page 446 that an individual’s grade modifier 

for physical findings is determined by objective sensory loss findings (observed after a specific 

testing regimen) and motor loss findings (due to recognized neurologic atrophy of innervated 

muscle). He indicated that Dr. Fritzhand found diminished pinprick and light touch in the right 

medial nerve distribution, but noted that he did not perform proper two-point discrimination 

testing. The DMA noted that Dr. Fritzhand’s use of a discriminator wheel to test for two-point 

discrimination and light touch was inappropriate because the number of millimeters between the 

two points tested must first be measured and then applied to the skin to determine the minimum

number of millimeters between the two points in order to determine if the discrimination is within 

normal limits (six millimeters or less).

7

 He found that the average of appellant’s three grade 

modifiers fell under grade modifier 1 with a default impairment value of two percent. The DMA 

determined that appellant’s severe QuickDASH score of 68 was invalid given her mild findings8

and concluded that, because there was no movement from the default impairment value derived 

from Table 15-23, the total permanent impairment of appellant’s right upper extremity was two 

percent. 

By decision dated December 15, 2016, OWCP denied appellant’s request for an increased 

schedule award. It based its determination on the opinion of the DMA.

 

7 The DMA referenced the process for correctly measuring two-point discrimination on page 424 and 426 of the 

A.M.A., Guides. He also indicated that appellant had no atrophy or muscle loss associated with the right median 

nerve. 

8 The DMA indicated the A.M.A., Guides provides on page 445 that, when the QuickDASH score exceeds 60 in 

the context of mild physical findings, there may be other diagnoses being overlooked which impact the subject’s 

answers and, therefore, the score is considered to be invalid.
6

On December 20, 2016 appellant, through counsel, requested a telephonic hearing before 

a representative of OWCP’s Branch of Hearings and Review. During the June 13, 2017 hearing, 

counsel argued that OWCP should have accepted the impairment rating of Dr. Fritzhand. 

By decision dated August 23, 2017, OWCP’s hearing representative vacated the 

December 15, 2016 decision and remanded the case to OWCP for further development. She 

determined that neither the DMA nor Dr. Fritzhand applied FECA Bulletin No. 17-06 which 

requires consideration of both a diagnosis-based impairment rating method and a range of motion 

impairment rating method when calculating permanent impairment due to certain upper extremity

conditions. The hearing representative directed OWCP, upon remand, to refer appellant to a 

second opinion physician for an examination and proper evaluation of permanent impairment 

under the sixth edition of the A.M.A., Guides. 

On August 31, 2017 OWCP referred appellant for a second opinion evaluation with

Dr. Anbu K. Nadar, a Board-certified orthopedic surgeon. In a November 14, 2017 report,

Dr. Nadar discussed appellant’s complaints of residual pain and numbness in her right hand, 

occasional numbness in her right thumb and index finger, and some difficulty in gripping with her 

right hand. He noted that he conducted a physical examination on September 20, 2017 which 

revealed a well-healed incision over the palm of appellant’s right hand, tenderness to deep 

palpation of her right wrist/hand, negative Tinel’s and Phalen’s signs, no thenar/hypothenar 

wasting, and two-point sensation of six millimeters involving her right thumb, index, and middle 

finger. Appellant had full range of motion of the right wrist with flexion to 70 degrees, extension 

to 70 degrees, radial deviation to 25 degrees, and ulnar deviation to 30 degrees. Dr. Nadar

provided an impairment rating utilizing Table 15-23 of the sixth edition of the A.M.A., Guides. 

He found that the findings of appellant’s EMG/NCV study fell under grade modifier 1 for test 

findings and noted that appellant continued to have intermittent symptoms which qualified her for 

grade modifier 2 for history. Dr. Nadar determined that her physical examination findings were 

grossly within normal limits and fell under grade modifier 1 for physical findings. He averaged 

these grade modifiers and found that the appropriate grade modifier was 1.33, which he rounded 

down to 1. Dr. Nadar indicated that appellant’s condition fell under the default impairment value 

of two percent for grade modifier 1 and concluded that she had a total of two percent permanent 

impairment of the right upper extremity.9

On November 24, 2017 OWCP referred the case record, including Dr. Nadar’s 

November 14, 2017 report, to the DMA for review and an evaluation of appellant’s permanent 

impairment under the A.M.A., Guides.

In a December 11, 2017 report, the DMA noted that the A.M.A., Guides provides that the 

range of motion method does not apply to rating permanent impairment due to carpal tunnel 

syndrome. He then proceeded to calculate appellant’s right upper extremity impairment utilizing 

Table 15-23 on page 449 of the sixth edition of the A.M.A., Guides. The DMA determined that 

the June 20, 2013 EMG/NCV study showed that appellant fell under grade modifier 1 for test

findings because the study met the criteria for right carpal tunnel syndrome and demonstrated 

 

9 Dr. Nadar determined that the date of MMI was September 20, 2017, the date of his examination.
7

sensory and motor conduction delays associated with the right median nerve.10 He noted that 

appellant fell under grade modifier 1 for history because she only had mild intermittent symptoms

related to carpal tunnel syndrome. Appellant did not qualify for a higher grade modifier because 

there was no documentation that she was unable to perform at least one of the activities of daily 

living, that someone else consistently performed an activity of daily living for her, or that there 

was conduction block and/or axonal involvement on EMG/NCV testing. The DMA then assigned 

grade modifier 0 for physical findings given that two-point discrimination testing was normal (six 

millimeters of less) and that there was no documentation of atrophy or muscle loss associated with 

the right median nerve. He advised that the average of the three grade modifiers rounded to the 

nearest integer would be assigned grade modifier 1 with a default impairment value of two percent. 

The DMA noted that a QuickDASH score was not obtained, but determined that, given appellant’s 

mild symptoms, mild EMG/NCV findings, and no significant physical loss, she had a mild 

functional score which would also be assigned grade modifier 1. Therefore, appellant’s functional 

score did not require movement from the default impairment value of two percent. The DMA 

concluded that the total permanent impairment of appellant’s right upper extremity was two 

percent.11

By decision dated January 10, 2018, OWCP denied appellant’s claim for an increased 

schedule award. It based its determination on the opinion of the DMA.

On January 19, 2018 appellant, through counsel, requested a telephonic oral hearing before 

a representative of OWCP’s Branch of Hearings and Review. During the June 26, 2018 hearing, 

counsel argued that the DMA’s impairment rating was improper. By decision dated September 7, 

2018, OWCP’s hearing representative affirmed the January 10, 2018 decision.

LEGAL PRECEDENT

The schedule award provision of FECA12 and its implementing federal regulation13 set 

forth the number of weeks of compensation payable to employees sustaining permanent 

impairment from loss, or loss of use, of scheduled members or functions of the body. However, 

FECA does not specify the manner in which the percentage of loss shall be determined. For 

consistent results and to ensure equal justice under the law for all claimants, OWCP has adopted 

 

10 The DMA indicated that there was no conduction block and/or axonal involvement seen on the June 20, 2013 

EMG/NCV study which would warrant a greater grade modifier for test findings.

11 The DMA indicated that the date of MMI was September 20, 2017, the date of Dr. Nadar’s examination.

12 5 U.S.C. § 8107.

13 20 C.F.R. § 10.404.
8

the A.M.A., Guides as the uniform standard applicable to all claimants.14 As of May 1, 2009, the 

sixth edition of the A.M.A., Guides is used to calculate schedule awards.15

Impairment due to carpal tunnel syndrome is evaluated under the scheme found in Table 

15-23 (Entrapment/Compression Neuropathy Impairment) and accompanying relevant text.16 In 

Table 15-23, grade modifier levels (ranging from 0 to 4) are described for the categories test 

findings, history, and physical findings. The grade modifier levels are averaged to arrive at the 

appropriate overall grade modifier level and to identify a default rating value. The default rating 

value may be modified up or down by one percent based on functional scale, an assessment of 

impact on daily living activities.17

OWCP’s procedures provide that, after obtaining all necessary medical evidence, the file 

should be routed to OWCP’s medical adviser for an opinion concerning the nature and percentage 

of impairment in accordance with the A.M.A., Guides, with OWCP’s medical adviser providing 

rationale for the percentage of impairment specified.18

ANALYSIS

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

percent permanent impairment of her right upper extremity, for which she previously received a 

schedule award. 

In his December 11, 2017 report, the DMA properly calculated appellant’s right upper 

extremity impairment utilizing Table 15-23 of the sixth edition of the A.M.A., Guides.

19

 He

determined that the June 20, 2013 EMG/NCV study showed that appellant fell under grade 

modifier 1 for test findings because the study, which demonstrated sensory and motor conduction 

delays, met the criteria for right carpal tunnel syndrome.20 The DMA noted that appellant fell 

under grade modifier 2 for history because she only had mild intermittent symptoms in her right 

upper extremity. He then assigned grade modifier 0 for physical findings given that two-point 

discrimination testing was normal and that there was no documentation of atrophy or muscle loss 

associated with the right median nerve. The average of the three grade modifiers was rounded to 

 

14 Id.

15 Federal (FECA) Procedure Manual, Part 2 -- Claims, Schedule Award and Permanent Disability Claims, Chapter 

2.808.5a (March 2017); Federal (FECA) Procedure Manual, Part 3 -- Medical, Schedule Awards, Chapter 3.700.2 and

Exhibit 1 (January 2010).

16 See A.M.A., Guides 449, Table 15-23.

17 A survey completed by a given claimant, known by the name QuickDASH, may be used to determine the 

functional scale score. Id. at 448-49.

18 See supra note 15 at Chapter 2.808.6(d) (March 2017). 

19 A.M.A., Guides 449, Table 15-23.

20 The DMA indicated that there was no conduction block and/or axonal involvement seen on the June 20, 2013 

EMG/NCV study which would warrant a greater grade modifier for test findings.
9

the nearest integer and assigned grade modifier 1 with a default impairment value of two percent. 

The DMA noted that a QuickDASH score was not obtained, but properly determined that, given 

appellant’s mild symptoms, mild EMG/NCV findings, and no significant physical loss, she had a 

mild functional score of grade modifier 1 which did not require movement from the default 

impairment value of two percent.

21

 The DMA correctly concluded that the total permanent 

impairment of appellant’s right upper extremity was two percent.22

The case record contains reports of Dr. Fritzhand, an attending physician, which includes 

higher impairment rating calculations for the right upper extremity,23 but the Board finds that

Dr. Fritzhand’s impairment rating analysisis of little probative value because he did not adequately 

explain how his calculations were conducted in accordance with the standards of the sixth edition 

of the A.M.A., Guides.

24

 The DMA properly identified the deficiencies in Dr. Fritzhand’s 

impairment rating analysis.25 For example, he explained that it was improper for Dr. Fritzhand to 

assign grade modifier 2 for history (rather than grade modifier 1) because appellant did not qualify 

for this higher grade modifier given there was no documentation that she was unable to perform at 

least one of the activities of daily living, that someone else consistently performed an activity of 

daily living for her, or that there was conduction block and/or axonal involvement on EMG/NCV 

testing.26 The DMA also explained that it was improper for Dr. Fritzhand to assign grade modifier 

2 for physical findings (rather than grade modifier 1) because Dr. Fritzhand did not conduct a 

proper evaluation of sensory loss under the standards of the sixth edition of the A.M.A., Guides.27 

 

21 See A.M.A., Guides 449.

22 The Board notes that Dr. Nadar assigned higher grade modifiers for history and physical examination than the 

DMA, but he did not provide any notable explanation for these ratings and Dr. Nadar ultimately found the same level 

of permanent impairment for the right upper extremity as the DMA, i.e., two percent. OWCP requested that Dr. Nadar 

use the range of motion rating method for evaluating appellant’s permanent impairment due to right carpal tunnel 

syndrome, but he, like the DMA, applied the appropriate method found at Table 15-23. See supra note 16.

23 In September 20, 2014 and August 20, 2016 reports, Dr. Fritzhand determined that appellant had six percent 

permanent impairment of her right upper extremity.

24 See N.A., Docket No. 19-0248 (issued May 17, 2019); James Kennedy, Jr., 40 ECAB 620, 626 (1989) (finding 

that an opinion which is not based upon the standards adopted by OWCP and approved by the Board as appropriate 

for evaluating schedule losses is of little probative value in determining the extent of a claimant’s permanent 

impairment).

25 The DMA directly evaluated Dr. Fritzhand’s opinion on permanent impairment in reports dated May 22 and 

October 10, 2016.

26 See A.M.A., Guides 433.

27 See id. at 424, 426. The DMA properly explained that Dr. Fritzhand’s use of a discriminator wheel to test for 

two-point discrimination and light touch was inappropriate because use of this device did not allow for proper sensory 

testing. He indicated that the number of millimeters between the two points tested had to first be measured and then 

applied to the skin to determine the minimum number of millimeters between the two points in order to determine if 

the discrimination was within normal limits (six millimeters or less). See id.
10

He also correctly found that Dr. Fritzhand’s calculation of appellant’s functional scale was invalid

and did not require movement from the default impairment value described in Table 15-23.28 

There is no probative medical evidence of record demonstrating that appellant sustained 

more than two percent permanent impairment of her right upper extremity due to her accepted 

condition of right carpal tunnel syndrome, for which she previously was received a schedule 

award.

Appellant may request a schedule award or increased schedule award at any time based on 

evidence of a new exposure or medical evidence showing progression of an employment-related 

condition resulting in permanent impairment or increased impairment. 

CONCLUSION

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

percent permanent impairment of her right upper extremity, for which she previously received a 

schedule award. 

ORDER

IT IS HEREBY ORDERED THAT the September 7, 2018 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: August 10, 2020

Washington, DC

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

 

28 The DMA determined that the QuickDASH score of 68 obtained by Dr. Fritzhand was invalid given appellant’s 

mild findings. He properly noted that, under the sixth edition of the A.M.A., Guides, when the QuickDASH score 

exceeds 60 in the context of mild physical findings, there may be other diagnoses being overlooked which impact the 

subject’s answers and, therefore, the score is considered to be invalid. See id. at 445.