United States Department of Labor

Employees’ Compensation Appeals Board

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D.B., Appellant

and

DEPARTMENT OF THE TREASURY, 

INTERNAL REVENUE SERVICE, OFFICE OF 

THE CHIEF COUNSEL, Washington, DC, 

Employer

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Docket No. 20-0775

Issued: July 28, 2021

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

JANICE B. ASKIN, Judge

PATRICIA H. FITZGERALD, Alternate Judge

JURISDICTION

On February 18, 2020 appellant filed a timely appeal from August 27, 2019 and

January 17, 2020 merit decisions 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

 

1 5 U.S.C. § 8101 et seq. 

2 The Board notes that, following the January 17, 2020 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.
2

ISSUE

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

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

FACTUAL HISTORY

On June 19, 2019 appellant, then a 35-year-old management assistant, filed an occupational 

disease claim (Form CA-2) alleging that on or before June 16, 2019 he sustained a ganglion cyst 

of the left thumb when working on a print, copy, label, project while in the performance of duty. 

He noted that a three-ring binder must have hit his hand. Appellant “noticed a knot of the wrist 

over the weekend” and reported the condition to his supervisor on June 18, 2019. 

In a June 18, 2019 report, Dr. Dani S. Boulattouf, a Board-certified family practitioner, 

diagnosed a left thumb sprain. 

In a development letter dated June 25, 2019, OWCP informed appellant of the deficiencies 

of his claim. It advised him of the type of factual and medical evidence required and provided a 

questionnaire for his completion. OWCP afforded appellant 30 days to submit the necessary 

evidence. 

In response, appellant provided a July 9, 2019 statement asserting that on June 14, 2019 

his left hand hit against a large binder while assisting an attorney with a “print and copy and label”

project. He noted that he performed these duties often for up to eight hours per day. Appellant

described constant left wrist pain, aggravated by typing. 

In a July 19, 2019 statement, Supervisor T.B. confirmed that appellant’s job duties required 

scanning and copying large case files, removing staples and binding clips from stacks of 

documents, and placing documents into three-ring binders. The employing establishment provided 

a September 26, 2017 official position description. 

Appellant subsequently provided an additional portion of Dr. Boulattouf’s June 18, 2019 

report, diagnosing a left thumb sprain with a small ganglion cyst. Dr. Boulattouf indicated that 

appellant believed that the diagnosed conditions were work related. In an August 7, 2019 report,

he diagnosed a left wrist ganglion and left thumb sprain. 

By decision dated August 27, 2019, OWCP denied appellant’s occupational disease claim,

finding that the evidence of record was insufficient to establish that the alleged employment factors 

occurred as described. 

On September 5, 2019 appellant requested a telephonic hearing before a representative of 

OWCP’s Branch of Hearings and Review. 

OWCP subsequently received a supplemental version of Dr. Boulattouf’s June 18, 2019 

report, wherein he diagnosed a left wrist sprain with a small ganglion cyst. 

During the hearing, held on December 6, 2019, appellant contended that he sustained 

injuries to both upper extremities due to repetitive motion while typing, moving boxes, lifting 
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heavy case files, and working on binder projects while in the performance of duty. He identified

a June 14, 2019 incident when a binder fell on both of his hands. Appellant thereafter submitted

additional medical evidence.

In a December 15, 2019 report, Dr. Boulattouf explained that the exact cause of the

ganglion cyst on appellant’s left wrist was not known, but usually is related to tendon sheath 

inflammation or irritation which can happen from a repetitive minor injury. He noted that appellant 

had pain from repetitive motion such as typing, lifting cases, or moving boxes which “probably 

irritated the whole thing.” He prescribed a left wrist splint. 

By decision dated January 17, 2020, the hearing representative modified the August 27, 

2019 decision to find that appellant had established the identified work factors as factual. The 

claim remained denied, however, as the medical evidence of record was insufficient to establish 

causal relationship between the diagnosed conditions and the accepted employment factors. 

LEGAL PRECEDENT

An employee seeking benefits under FECA3has 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 of FECA,4that 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.5 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.6

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

disease claim, an employee must submit 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.7

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 

 

3 Supra note 1.

4

J.P., Docket No. 19-0129 (issued April 26, 2019); S.B., Docket No. 17-1779 (issued February 7, 2018); Joe D. 

Cameron, 41 ECAB 153 (1989).

5

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

ECAB 312 (1988).

6 R.R., Docket No. 19-0048 (issued April 25, 2019); L.M., Docket No. 13-1402 (issued February 7, 2014); 

Delores C. Ellyett, 41 ECAB 992 (1990).

7 S.D., Docket No. 20-0413 (issued July 28, 2020); L.S., Docket No. 19-1769 (issued July 10, 2020); R.G., Docket 

No. 19-0233 (issued July 16, 2019). See also Roy L. Humphrey, 57 ECAB 238, 241 (2005); Ruby I. Fish, 46 ECAB 

276, 279 (1994); Victor J. Woodhams, 41 ECAB 345 (1989).
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opinion evidence.8 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 

the specific employment factor(s) identified by the employee.9 The weight of the 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

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

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

In support of his occupational disease claim, appellant provided June 18 and August 7, 

2019 reports from Dr. Boulattouf diagnosing a left thumb sprain and left wrist ganglion cyst. 

Dr. Boulattouf explained in a December 15, 2019 report that the cause of the ganglion cyst on 

appellant’s left wrist was not known, but was usually related to tendon sheath inflammation or 

irritation which can happen from a repetitive minor injury. He noted that appellant had pain from 

repetitive motion such as typing, lifting cases, or moving boxes which “probably irritated the 

whole thing.” His opinion is speculative in nature as he identified only a possible cause of the 

ganglion cyst. The Board has held that medical opinions that are speculative or equivocal are of 

diminished probative value.11 Also, without explaining how the frequent and repetitive actions of 

appellant’s employment caused or aggravated his left thumb sprain and ganglion cyst,

Dr. Boulattouf’s reports are of limited probative value.12

As appellant has not submitted rationalized medical evidence establishing that his 

diagnosed upper extremity conditions were causally related to the accepted factors of his federal 

employment, the Board finds that he has not met his burden of proof to establish his claim.

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 an upper 

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

 

8 S.D., id.; S.A., Docket No. 18-0399 (issued October 16, 2018); Robert G. Morris, 48 ECAB 238 (1996).

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

note 7.

10 D.R., Docket No. 19-0954 (issued October 25, 2019); James Mack, 43 ECAB 321 (1991).

11 J.I., Docket No. 20-1374 (issued March 3, 2021); H.A., Docket No. 18-1455 (issued August 23, 2019).

12 J.I., id.; see A.P., Docket No. 19-0224 (issued July 11, 2019).
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ORDER

IT IS HEREBY ORDERED THAT the January 17, 2020 and August 27, 2019 decisions

of the Office of Workers’ Compensation Programs is affirmed.

Issued: July 28, 2021

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board