United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

A.L., Representative of the Estate of M.G., 

Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Bellmawr, NJ, Employer

__________________________________________

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Docket No. 18-1016

Issued: March 6, 2020

Appearances: Case Submitted on the Record

Thomas R. Uliase, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

JANICE B. ASKIN, Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On April 19, 2018 appellant filed a timely appeal from a January 5, 2018 merit decision of 

the Office of Workers’ Compensation Programs (OWCP).2 Pursuant to the Federal Employees’

 

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 The employee passed away on September 10, 2017. 
2

Compensation Act3(FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board has jurisdiction over 

the merits of this case.4

ISSUE

The issue is whether appellant has met her burden of proof to establish a bilateral upper 

extremity condition causally related to the accepted factors of the employee’s federal employment.

FACTUAL HISTORY

This case has previously been before the Board.5 The facts and circumstances as set forth 

in the prior Board decision are incorporated herein by reference. The relevant facts are set forth 

below. 

On January 4, 2015 the employee then a 53-year-old mail handler, filed an occupational 

disease claim (Form CA-2), alleging that she developed carpal tunnel syndrome as a result of 

performing repetitive duties required by her federal employment. She became aware of her 

condition on November 3, 2014 and realized that it was causally related to factors of her federal 

employment on December 17, 2014. The employee stopped work on January 9, 2015.

The employee came under the treatment of Dr. John M. Bednar, a Board-certified 

orthopedist, who, in a January 9, 2015 report, diagnosed median neuropathy, bilateral carpal tunnel 

syndrome, bilateral ulnar neuropathy, bilateral cubital tunnel syndrome, and degenerative arthritis 

of the carpometacarpal joint, thumb and left elbow. Dr. Bednar noted that the employee’s history 

was significant for diabetes. He returned the employee to light duty.

By decision dated April 6, 2015, OWCP denied the employee’s occupational disease claim 

because she failed to establish that her claimed medical condition was causally related to the 

established employment factors.

On April 14, 2015 the employee requested an oral hearing before a representative of 

OWCP’s Branch of Hearings and Review, which was held on July 9, 2015.

On April 22, 2015 Dr. Bednar diagnosed median neuropathy, bilateral carpal tunnel 

syndrome, bilateral ulnar neuropathy, bilateral cubital tunnel syndrome, degenerative arthritis of 

the carpometacarpal joint, thumb and left elbow, and flexor tenosynovitis of the left thumb and 

left index finger. He opined that the causality of the median and ulnar neuropathy and flexor 

tenosynovitis diagnoses was multifactorial. Dr. Bednar noted that the employee’s diabetes did 

“have some causal relation with regards to these diagnoses,” but opined that the employee’s “work 

 

3 5 U.S.C. § 8101 et seq.

4 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.

5 Docket No. 16-1791 (issued February 22, 2017).
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history and work activities as a postal handler were responsible for material worsening of these 

diagnoses and the resultant impairment.”

In a decision dated September 3, 2015, an OWCP hearing representative affirmed the 

April 6, 2015 decision.

On September 25, 2015 the employee requested reconsideration. She submitted a 

January 16, 2015 electromyogram (EMG), which revealed severe left subacute carpal tunnel 

syndrome, moderate right chronic carpal tunnel syndrome, and left chronic cubital tunnel 

syndrome. A May 22, 2015 EMG revealed moderate left chronic carpal tunnel syndrome and 

early/mild right chronic carpal tunnel syndrome.

On July 20, 2015 Dr. Bruce Monaghan, a Board-certified orthopedist, evaluated the 

employee for pain in both hands and arms that had been present since November 2014. He noted 

that she attributed her symptoms to pushing and pulling heavy equipment and repetitive lifting of 

mail and mail tubs. X-rays of both elbows were unremarkable and x-rays of the wrists and thumb 

revealed basilar joint arthritis. Dr. Monaghan diagnosed bilateral carpal tunnel syndrome and 

ulnar neuropathy, left index finger and left thumb stenosing tenosynovitis, bilateral thumb 

carpometacarpal degenerative joint disease, and possible fibromyalgia. He recommended carpal 

tunnel braces, diagnostic injections, and continued limited duty. 

In reports dated August 3 and 31, 2015, Dr. Monaghan found positive Tinel’s sign in both 

hands and tenderness over the A1 pulley of her left thumb and index finger. He administered a 

steroid injection of both thumb and index finger with improvement in symptoms. On 

September 23, 2015 Dr. Monaghan recommended endoscopic carpal tunnel release and A1 pulley 

release of the thumb and index finger on the left hand.

On October 29, 2015 the employee underwent left index finger A1 pulley release traction 

tenolysis, left thumb A1 pulley release, and left endoscopic carpal tunnel release.6 

By decision dated May 18, 2016, OWCP denied modification of the September 3, 2015

decision.

The employee, through counsel, appealed to the Board. By decision dated February 22, 

2017,7the Board affirmed the May 18, 2016 decision, finding that she failed to establish that her 

diagnosed medical conditions were related to the accepted employment factors.

On October 13, 2017 counsel requested reconsideration and submitted an August 9, 2017

report from Dr. Monaghan. Counsel asserted that Dr. Monaghan related the employee’s bilateral 

carpal tunnel syndrome and tenosynovitis of the left thumb and middle finger to repetitive work 

duties performed in her clerk position.

In a report dated August 9, 2017, Dr. Monaghan indicated that the employee’s job as a mail 

handler involved pushing and pulling heavy equipment, repetitive lifting of mail and mail tubs,

and repetitive grasping. He opined that, within a medical degree of certainty, the repetitive nature 

 

6 The full October 29, 2011 operative report is not in the record.

7 Supra note 4.
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of her job either caused the onset or exacerbation of the symptoms referable to her carpal tunnel 

syndrome and tenosynovitis of the left thumb, index and middle finger. Dr. Monaghan advised 

that it was well known that repetitive grasping and gripping was a risk factor for carpal tunnel 

syndrome and trigger-finger. He opined that, while the causes may be multifactorial, the nature of 

the employee’s work was significant and predominantly responsible for the worsening of these 

diagnoses and impairment of her hand function. Dr. Monaghan cited to the February 2016 article

published in the Journal of the American Academy of Orthopedic Surgeons, which supported high 

hand and wrist repetition rates were associated with increased risk of developing carpal tunnel 

syndrome.

By decision dated January 5, 2018, OWCP denied modification of the decision dated 

February 22, 2017.

LEGAL PRECEDENT

An employee seeking benefits under FECA8 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 filed within the applicable time limitation 

period of FECA,9that an injury was sustained while in the performance of duty, as alleged, and 

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

the employment injury.10 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.11

In an occupational disease claim, appellant’s burden requires submission of 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 employment factors 

identified by the employee.12

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

relationship is rationalized medical opinion evidence.13 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 

 

8 Supra note 2.

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

153 (1989).

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

ECAB 312 (1988).

11 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).

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

13 A.M., Docket No. 18-1748 (issued April 24, 2019); T.H., 59 ECAB 388 (2008).
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relationship between the diagnosed condition and the specific employment factors identified by 

the claimant.14

ANALYSIS

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

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

Preliminarily, the Board notes that it is unnecessary to consider the evidence submitted 

prior to the issuance of OWCP’s May 18, 2016 decision because the Board has already considered 

that evidence in its February 22, 2017 decision.15 Findings made in prior Board decisions are 

res judicata absent any further review by OWCP under section 8128 of FECA.16

In support of his reconsideration request, counsel submitted an August 9, 2017 report from

Dr. Monaghan, who noted that the employee’s job duties required repetitive lifting, grasping, and 

pushing and pulling heavy equipment. Dr. Monaghan opined that her employment duties either 

caused or aggravated her carpal tunnel syndrome and tenosynovitis of the left thumb, index and 

middle fingers. He found that, while the causes may be multifactorial, the repetitive nature of the 

employee’s job duties had significantly worsened her diagnosed conditions and her impaired hand 

function. The Board notes that, while his report provides some support for causal relationship, it 

is insufficient to establish that the claimed conditions are causally related to her employment 

duties. Dr. Monaghan failed to offer sufficient medical rationale explaining how the employee’s 

diagnosed bilateral carpal tunnel syndrome and tenosynovitis of the left thumb, index, and middle 

finger was caused or aggravated by her employment duties.17 He referenced the repetitive nature 

of her work without explaining how physiologically specific employment factors caused or 

aggravated the diagnosed condition.18 Dr. Monaghan referenced a medical article as support of 

his opinion. However, the Board has held that newspaper clippings, medical texts, and excerpts 

from publications are of no evidentiary value in establishing the causal relationship between a 

claimed condition and an employee’s federal employment as such materials are of general 

application and are not determinative of whether the specific condition claimed is related to the 

particular employment factors alleged by the employee.19 For these reasons, the Board finds that 

the August 9, 2017 report from Dr. Monaghan is insufficient to establish the claim.

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

establish causal relationship.20 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 

 

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

15 C.T., Docket No. 19-0508 (issued September 5, 2019).

16 T.H., Docket No. 18-1585 (issued March 22, 2019).

17 See A.B., Docket No. 19-0617 (issued October 3, 2019); Calvin E. King, Jr., 51 ECAB 394 (2000).

18 C.E., Docket No. 19-0192 (issued July 16, 2019).

19 A.M., Docket No. 18-0562 (issued January 23, 2020); William C. Bush, 40 ECAB 1064, 1075 (1989).

20 L.A., Docket No. 19-0820 (issued December 6, 2019).
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a causal relationship.21 As appellant has not submitted medical evidence establishing causal 

relationship between the accepted employment factors and the employee’s claimed conditions, she 

has not met her burden of proof.22

On appeal counsel disagrees with OWCP’s decision denying her claim for compensation 

and noted that she submitted sufficient evidence to establish her claim. As found above, however,

Dr. Monaghan failed to provide sufficient rationale explaining how the diagnosed conditions were 

causally related to the accepted employment factors.

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 bilateral upper 

extremity condition causally related to the accepted factors of the employee’s federal employment. 

ORDER

IT IS HEREBY ORDERED THAT the January 5, 2018 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: March 6, 2020

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

 

21 S.G., Docket No. 18-1373 (issued February 12, 2019); D.D., 57 ECAB 734 (2006).

22 C.M., Docket No. 19-0264 (issued December 19, 2019).