United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

R.A., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Shaker Heights, OH, Employer

__________________________________________

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Docket No. 17-1472

Issued: December 6, 2017

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

CHRISTOPHER J. GODFREY, Chief Judge

PATRICIA H. FITZGERALD, Deputy Chief Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On June 27, 2017 appellant, through counsel, filed a timely appeal from an April 6, 2017 

merit decision of the Office of Workers’ Compensation Programs (OWCP). 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.

ISSUE

The issue is whether appellant met his burden of proof to establish bilateral carpal tunnel 

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

 

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

5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY

On December 17, 2013 appellant, then a 54-year-old mail clerk, filed an occupational 

disease claim (Form CA-2) alleging that he developed a bilateral injury to his arms and hands as 

a result of factors of his federal employment. He reported that from 1983 to 1992 he worked on 

the conveyer belt as a mail handler, loading heavy boxes and sacks. Appellant stopped work due 

to a September 22, 1992 work-related back injury and returned in 1993 to perform limited-duty 

office clerk work; OWCP assigned File No. xxxxxx782. He performed office work from 1993 to 

2009 which involved repetitive activities of filing and typing on a computer. Appellant was then 

sent for office management systems training on October 21, 2010. He reported first being

diagnosed with carpal tunnel syndrome (CTS) on March 14, 2007. Appellant first became aware 

of his condition and of its relationship to his federal employment duties on October 21, 2010. He 

further reported that initially he filed a traumatic injury claim (Form CA-1) for his injury because 

he did not know that it was really an occupational disease claim.3 On the reverse side of the 

claim form, appellant’s supervisor reported that he was no longer on the periodic rolls and that 

he had retired on January 12, 2011.

By letter dated December 27, 2013, OWCP informed appellant that the evidence of 

record was insufficient to support his claim. Appellant was advised of the medical and factual 

evidence necessary and was afforded 30 days to submit the necessary evidence. No evidence 

was received within the required time frame.

By decision dated February 10, 2014, OWCP denied appellant’s claim finding that the 

evidence of record failed to establish that the occupational exposure occurred as alleged.

On February 18, 2014 appellant, through counsel, requested a telephone hearing before 

an OWCP hearing representative.

In support of his hearing request appellant submitted additional evidence. In a March 19, 

2007 diagnostic report from Dr. Karen Murata, Board-certified in physical medicine and 

rehabilitation, related that an electrodiagnostic study revealed findings consistent with median 

neuropathy of bilateral wrists, and mild bilateral carpal tunnel syndrome. 

In a February 19, 2013 work status report, Dr. Steve Huang, Board-certified in nuclear 

medicine, noted an October 15, 2010 date of injury and diagnosed carpal tunnel syndrome. He

provided work restrictions and checked a box marked “yes” indicating that the diagnosed 

condition was work related.

In a May 14, 2014 industrial work status report, Dr. Bhavesh Pandya, Board-certified in 

occupational medicine, noted a September 22, 1992 date of injury and provided appellant 

permanent work restrictions under File No. xxxxxx782. 

At the August 13, 2014 hearing, appellant explained that he was initially employed at the 

employing establishment as a mail handler which required lifting heavy sacks and boxes. After 

 

3 Appellant’s traumatic injury claim for carpal tunnel syndrome was denied under File No. xxxxxx334. The 

record before the Board contains no other information pertaining to this claim.
3

his 1992 injury, he was placed on light duty and performed office work. Appellant attributed his 

bilateral CTS to his repetitive employment duties after he began to experience numbness, pain, 

and tingling in his bilateral upper extremities. He reported that he was first diagnosed with CTS 

in 2007. Appellant stated that in 2009, the employing establishment informed him that they 

could no longer provide him with limited duty and sent him for a six-month office management

training course. The course involved typing on a computer and his carpal tunnel continued to

cause symptoms, for which he sought medical attention and filed this occupational disease claim.

By decision dated October 23, 2014, OWCP’s hearing representative affirmed the 

February 10, 2014 decision, finding that the evidence of record failed to establish that the 

occupational exposure occurred as alleged. He noted that there were inconsistencies in the 

evidence as to the time, place, and manner of the alleged injury since appellant had attributed his 

symptoms to varying causes. 

On January, 6, 2015 appellant, through counsel, requested reconsideration of OWCP’s

decision. Counsel noted submission of medical reports from Dr. Huang not previously 

considered in support of appellant’s claim. 

In an October 25, 2010 diagnostic report, Dr. Nazanin Matloubi, a Board-certified 

neurologist, reported that appellant complained of right hand numbness for the past few years 

which had worsened during the past two weeks. Electromyography and nerve conduction 

velocity (EMG/NCV) studies of the right upper extremity performed on that date revealed 

abnormal findings. Dr. Matloubi noted electrodiagnostic evidence of right median 

mononeurapathy across the wrist such as seen in carpal tunnel syndrome, mild in degree. 

In medical reports dated November 8 and 9, 2010, and February 19, 2013, Dr. Huang 

noted that appellant reported repetitive use of his arm and hand while typing. Appellant 

attributed his symptoms to repetitive typing, noting that he developed pain, numbness, and 

tingling in the right hand. Dr. Huang noted appellant’s occupation as a clerical typist which 

involved prolonged computer work/typing. He reviewed the EMG/NCV study and diagnosed 

carpal tunnel syndrome. Dr. Huang provided appellant work restrictions and checked a box

marked “yes” indicating that the diagnosed condition was work related.

By decision dated March 10, 2015, OWCP affirmed the October 23, 2014 decision, as 

modified, finding that the evidence of record failed to establish that his diagnosed condition was 

causally related to the accepted factors of his federal employment. It noted that appellant 

established fact of injury. However, the medical evidence of record failed to establish a causal 

relationship between his carpal tunnel syndrome and the accepted factors of his federal 

employment. 

On February 9, 2016 appellant, through counsel, requested reconsideration of OWCP’s

decision. Counsel noted submission of medical reports from Kaiser Permanente which were not 

previously considered. 

In support of his claim, appellant resubmitted medical evidence previously of record as 

well as a December 3, 2010 medical report from Dr. Huang virtually identical to his prior 

reports. Dr. Huang diagnosed carpal tunnel syndrome and provided appellant work restrictions. 
4

By decision dated April 6, 2017, OWCP affirmed the March 10, 2015 decision finding 

that the evidence of record failed to establish that his diagnosed carpal tunnel syndrome was

causally related to the accepted factors of his federal employment.

LEGAL PRECEDENT

An employee seeking benefits under FECA4has 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 filed within the applicable time 

limitation, that 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.5 These are the essential elements of every compensation claim regardless of 

whether the claim is predicated on a traumatic injury or an occupational disease.6

In order to determine whether an employee actually sustained an injury in the 

performance of duty, OWCP begins with an analysis of whether fact of injury has been 

established. Generally, fact of injury consists of two components which must be considered in 

conjunction with one another. The first component to be established is that the employee 

actually experienced the employment incident which is alleged to have occurred.7 The second 

component is whether the employment incident caused a personal injury and generally can be 

established only by medical evidence. 

To establish that an injury was sustained in the performance of duty in a claim for 

occupational disease, an employee 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 employee.8

To establish causal relationship between the 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.9 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. This medical opinion must include an accurate history of the employee’s 

employment injury and must explain how the condition is related to the injury. The weight of 

 

4

Supra note 2.

5 Gary J. Watling, 52 ECAB 278 (2001); Elaine Pendleton, 40 ECAB 1143, 1154 (1989).

6 Michael E. Smith, 50 ECAB 313 (1999).

7 Elaine Pendleton, supra note 5. 

8

See Roy L. Humphrey, 57 ECAB 238, 241 (2005); Ruby I. Fish, 46 ECAB 276, 279 (1994). 

9

See 20 C.F.R. § 10.110(a); John M. Tornello, 35 ECAB 234 (1983).
5

medical evidence is determined by its reliability, its probative value, its convincing quality, the 

care of analysis manifested, and the medical rationale expressed in support of the physician’s 

opinion.10

ANALYSIS

OWCP accepted that appellant engaged in repetitive activities of typing in his

employment duties as a mail clerk. It denied his claim, however, finding that the evidence of 

record failed to establish a causal relationship between the accepted employment factors and his 

bilateral carpal tunnel syndrome. 

The Board finds that the medical evidence of record is insufficient to establish that 

appellant developed bilateral carpal tunnel syndrome causally related to the accepted factors of 

his federal employment as a mail clerk.

In support of his claim, appellant submitted medical reports dated November 8, 2010 

through February 19, 2013 from Dr. Huang who documented treatment for his carpal tunnel 

syndrome. Dr. Huang’s reports lack the specificity and detail needed to establish that appellant’s 

injuries are a result of a work-related occupational exposure.11 While he provided a diagnosis of 

carpal tunnel syndrome, he failed to provide a fully-rationalized opinion on the cause of 

appellant’s condition. In his reports, Dr. Huang checked a box marked “yes” indicating that the 

diagnosed condition was work related. The Board has held that a report that addresses causal 

relationship with a checkmark, without medical rationale explaining how the work condition 

caused the alleged injury, is of diminished probative value and insufficient to establish causal 

relationship.12 Moreover, Dr. Huang failed to sufficiently discuss appellant’s employment 

duties, only generally noting prolonged computer work/typing. While he had some 

understanding of these employment duties, he failed to detail how long appellant worked as a 

typist, the number of hours per day spent performing each task, and the frequency of the physical 

movements which appellant attributes to his injury. Dr. Huang’s statement on causation failed to 

provide a sufficient explanation as to the mechanism of injury pertaining to this occupational 

disease claim as alleged by appellant, namely, how repetitive typing would cause or aggravate 

his bilateral carpal tunnel syndrome.

13

 Without explaining how physiologically the movements 

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

opinion on causal relationship is equivocal in nature and of limited probative value.14 

The remaining medical evidence of record is also insufficient to establish appellant’s 

occupational disease claim. Dr. Murata and Dr. Matloubi’s diagnostic reports only interpreted 

 

10 James Mack, 43 ECAB 321 (1991).

11 P.O., Docket No. 14-1675 (issued December 3, 2015); S.R., Docket No. 12-1098 (issued September 19, 2012).

12 See Calvin E. King, Jr., 51 ECAB 394 (2000); see also Frederick E. Howard, Jr., 41 ECAB 843 (1990).

13 S.W., Docket No. 08-2538 (issued May 21, 2009).

14 See L.M., Docket No. 14-973 (issued August 25, 2014); R.G., Docket No. 14-113 (issued April 25, 2014); 

K.M., Docket No. 13-1459 (issued December 5, 2013); A.J., Docket No. 12-548 (issued November 16, 2012).
6

imaging studies and provided no opinion on the cause of appellant’s injury.15 The Board has 

held that diagnostic reports are of limited probative value as they fail to provide an opinion on 

the causal relationship between appellant’s employment duties and the diagnosed conditions.16 

Without any mention of the specific repetitive employment duties, any carpal tunnel findings 

made could not be related to his claim to establish causal relationship.17 

Dr. Pandya’s industrial work status report is also of no probative value as the report was 

unrelated to this claim and pertained to his prior back injury. Any medical opinion evidence 

appellant may submit to support his claim should reflect a correct history and offer a medically 

sound explanation by the physician of how the specific employment factors caused or aggravated 

his bilateral carpal tunnel syndrome.

18

An award of compensation may not be based on surmise, conjecture, speculation, or on 

the employee’s own belief of causal relation.19 Appellant’s honest belief that his occupational 

employment duties caused his medical injury is not in question, but that belief, however 

sincerely held, does not constitute the medical evidence necessary to establish causal 

relationship.20 In the instant case, the record lacks rationalized medical evidence establishing a 

causal relationship between appellant’s federal employment duties as a mail clerk and his 

diagnosed bilateral carpal tunnel syndrome. Thus, appellant has failed to meet his burden of 

proof. 

Appellant may submit additional evidence, together with a written request for 

reconsideration, to OWCP within one year of the Board’s 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 carpal 

tunnel syndrome causally related to the accepted factors of his federal employment. 

 

15 D.H., Docket No. 11-1739 (issued April 18, 2012).

16 See S.G., Docket No. 17-1054 (issued September 14, 2017). 

17 S.Y., Docket No. 11-1816 (issued March 16, 2012).

18 M.R., Docket No. 14-11 (issued August 27, 2014).

19 D.D., 57 ECAB 734 (2006).

20 See J.S., Docket No. 17-0967 (issued August 23, 2017). 
7

ORDER

IT IS HEREBY ORDERED THAT the April 6, 2017 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: December 6, 2017

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board