United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

P.K., Appellant

and

DEPARTMENT OF VETERANS AFFAIRS, 

ORLANDO VETERANS ADMINISTRATION 

MEDICAL CENTER, Orlando, FL, Employer

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Docket No. 18-0766

Issued: February 18, 2020

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

JANICE B. ASKIN, Judge

ALEC J. KOROMILAS, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On February 26, 2018 appellant filed a timely appeal from a January 26, 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 over the merits of this case.

ISSUE

The issue is whether appellant met his burden of proof to establish bilateral upper extremity 

conditions causally related to the accepted factors of his federal employment.

FACTUAL HISTORY

On November 28, 2017 appellant, then a 60-year-old physician, filed an occupational 

disease claim (Form CA-2) for carpal tunnel syndrome, which he attributed to working on a 

 

1 5 U.S.C. § 8101 et seq.
2

computer while in the performance of duty. He indicated that he first became aware of his 

condition and first realized it was caused or aggravated by factors of his federal employment on 

June 1, 2017. Appellant did not stop work.

In a December 7, 2017 development letter, OWCP advised appellant of the deficiencies of 

his claim and afforded him 30 days to submit factual information and medical evidence in support 

of his claim for FECA benefits.

Dr. Vikram P. Mehta, a Board-certified hand surgeon, in a September 20, 2017 report, 

noted an assessment of bilateral wrist pain, bilateral primary osteoarthritis of the first 

carpometacarpal (CMC) joint, and paresthesia of the skin. He further noted that appellant was a 

right-handed nephrologist who presented “with at least a 6[-]month history of bilateral wrist pain 

and left[-]hand numbness with burning paresthesias and nocturnal discomfort in the left hand.”

Dr. Mehta observed that appellant had no medical problems and had no history of diabetes. He

also noted that appellant had undergone a nerve conduction which apparently showed left carpal 

tunnel syndrome. Dr. Mehta referred appellant for additional upper extremity diagnostic studies

to ascertain the cause of appellant’s hand numbness (paresthesia).

Dr. Harinder K. Sidhu, a Board-certified neurologist, indicated that the results of 

appellant’s October 19, 2017 left upper extremity electromyography and nerve conduction 

velocity (EMG/NCV) study revealed severe left carpal tunnel syndrome (CTS).

By decision dated January 26, 2018, OWCP denied appellant’s occupational disease claim 

because the medical evidence of record failed to establish a causal relationship between his 

diagnosed upper extremity conditions and the accepted factors of his federal employment. It 

concluded, therefore, that the requirements had not been met to establish an injury and/or condition 

causally related to the accepted employment factors. 

LEGAL PRECEDENT

An employee seeking benefits under FECA2 has the burden of proof to establish the 

essential elements of his or her claim, including 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,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

 

2

Id.

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).
3

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

disease claim, a claimant 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 claimant.6 

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

relationship is rationalized medical opinion evidence.7 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 specific employment factors identified by the employee.

8

ANALYSIS

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

extremity conditions causally related to the accepted factors of his federal employment.

In his September 20, 2017 report, Dr. Mehta diagnosed primary osteoarthritis of first CMC 

joint, bilaterally. He also reported findings of bilateral wrist pain and paresthesia of skin. 

Dr. Mehta referred appellant for electrodiagnostic studies to address the cause of his hand 

numbness.9 He noted that appellant was a physician, but did not otherwise address his specific 

duties. Dr. Mehta also did not provide an opinion regarding the cause of appellant’s bilateral first 

CMC joint osteoarthritis. The Board has held that medical evidence that does not offer an opinion 

regarding the cause of an employee’s condition is of no probative value on the issue of causal 

relationship.10 Therefore, Dr. Mehta’s September 20, 2017 report is insufficient to establish 

appellant’s claim.11

As the medical evidence of record does not contain a rationalized opinion establishing causal 

relationship between appellant’s bilateral upper extremity conditions and the accepted factors of his 

federal employment, the Board finds that appellant has not met his burden of proof.

 

6 S.C., Docket No. 18-1242 (issued March 13, 2019); R.H., 59 ECAB 382 (2008).

7 A.M., Docket No. 18-1748 (issued April 24, 2019); T.H., 59 ECAB 388, 393 (2008); Robert G. Morris, 48 ECAB 

238 (1996).

8 M.V., Docket No. 18-0884 (issued December 28, 2018); I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 ECAB 

345, 352 (1989).

9 Dr. Mehta noted having discussed with appellant a differential diagnosis of hand numbness and a clinical diagnosis 

of CTS.

10 See L.B., Docket No. 18-0533 (issued August 27, 2018); D.K., Docket No. 17-1549 (issued July 6, 2018).

11 Id.
4

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 bilateral upper 

extremity conditions causally related to the accepted factors of his federal employment.

ORDER

IT IS HEREBY ORDERED THAT the January 26, 2018 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: February 18, 2020

Washington, DC

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board