United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

J.V., Appellant

and

DEPARTMENT OF THE AIR FORCE, TRAVIS 

AIR FORCE BASE, CA, Employer

__________________________________________

)

)

)

)

)

)

)

)

Docket No. 20-1368

Issued: March 1, 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

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On July 6, 2020 appellant filed a timely appeal from an April 23, 2020 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 has met his burden of proof to establish more than 13 percent 

permanent impairment of his right upper extremity and 2 percent permanent impairment of his left 

thumb for which he received schedule award compensation.

 

1 5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY

This case has previously been before the Board.2 The facts and circumstances as set forth 

in the Board’s prior decision are incorporated herein by reference. The relevant facts are as 

follows.

On December 17, 2013 appellant, then a 56-year-old cargo scheduler, filed an occupational 

disease claim (Form CA-2) alleging that he sustained arthritis at the base of both thumbs causally 

related to factors of his federal employment.3 OWCP accepted the claim for localized primary 

osteoarthritis of the hands.

On May 7, 2015 appellant underwent an arthroplasty of the carpometacarpal (CMC) joint 

of the right thumb and a right one bone carpectomy and hemitrapeziectomy. He stopped work on 

May 7, 2015 and returned to work on July 20, 2015.

On November 25, 2015 appellant filed a claim for a schedule award (Form CA-7).

In a February 1, 2016 letter, OWCP requested that Dr. Chunbo C. Cai, a Board-certified 

physiatrist, submit an impairment evaluation addressing whether appellant had reached maximum 

medical improvement (MMI) and providing an impairment rating using the sixth edition of the 

A.M.A., Guides to the Evaluation of Permanent Impairment (A.M.A., Guides).4 

In a February 18, 2016 response, Dr. Cai advised that she did not perform impairment 

ratings using the sixth edition of the A.M.A., Guides. She opined that appellant had reached MMI

on January 28, 2016. Dr. Cai diagnosed osteoarthritis of the bilateral right first CMC joint. She 

found full strength of both wrists and measured range of motion (ROM) of the wrists and thumbs 

bilaterally.

On August 5, 2016 OWCP referred appellant to Dr. Aubrey A. Swartz, a Board-certified 

orthopedic surgeon, for a second opinion examination. 

In a September 6, 2016 impairment evaluation, Dr. Swartz discussed appellant’s 

complaints of numbness at the base of the right thumb around a branch of the radial nerve and pain 

at the base of both thumbs. He diagnosed an interposition arthroplasty of the CMC joint of the 

right thumb due to osteoarthritis, left thumb osteoarthritis at the CMC joint, a right 

hemitrapeziectomy for osteoarthritis of the right wrist at the scaphotrapezial joint, and status post 

arthroplasty of the scaphotrapezial joint of the right wrist. On examination Dr. Swartz found 

hyposthesias near the scar over the right thumb and right radial wrist and normal left thumb and 

wrist sensation. He measured ROM of the bilateral thumbs and wrists. Dr. Swartz advised that 

he was rating appellant’s right thumb impairment using the ROM method as the diagnosis-based 

impairment (DBI) method set forth at Table 15-2 on page 393 of the A.M.A., Guides applied only 

 

2 Docket No. 18-1052 (issued November 8, 2018).

3 OWCP previously accepted that appellant sustained a right foot contusion on September 9, 2003 under OWCP 

File No. xxxxxx622. 

4 A.M.A., Guides (6th ed. 2009).
3

with normal motion. Using the ROM method, he found 7 percent permanent impairment of the 

right thumb and 10 percent permanent impairment of the right wrist, for a total right upper 

extremity impairment of 13 percent. Dr. Swartz found no impairment of the left upper extremity 

using the ROM method. He further determined that appellant had no instability of the CMC joint 

and, thus, no impairment using the DBI method under Table 15-2.

On October 24, 2016 Dr. Michael M. Katz, a Board-certified orthopedic surgeon, serving 

as a district medical adviser (DMA), discussed appellant’s history of reconstructed surgery on the 

right thumb and a right hemitrapeziectomy for osteoarthritis of the right scaphotrapezial joint. He 

concurred with Dr. Swartz’ finding of 10 percent permanent impairment of the right upper 

extremity due to loss of ROM of the right wrist and 3 percent permanent impairment due to loss 

of ROM of the thumb, for a total right upper extremity impairment of 13 percent. Dr. Katz also 

concurred with his finding of no impairment of the left upper extremity. He noted that Dr. Swartz 

had properly rated the impairment using the ROM method as directed by the wrist regional grid at 

Table 15-3 and the digit regional grid at Table 15-2 in the absence of normal motion.

By decision dated December 20, 2016, OWCP granted appellant a schedule award for 13 

percent permanent impairment of the right upper extremity. It determined that he had no 

impairment of the left upper extremity. The period of the award ran from September 6, 2016 to 

July 16, 2017.

Appellant, on September 15, 2017, requested reconsideration.

By decision dated December 6, 2017, OWCP denied modification of its December 20, 

2016 decision.

Appellant appealed the Board. By decision dated November 8, 2018, the Board set aside 

the December 6, 2017 decision.5 It determined that Dr. Swartz had not obtained three independent 

ROM measurements prior to determining the extent of impairment in accordance with FECA 

Bulletin No. 17-06.6 The Board remanded the case for OWCP to obtain a supplemental report 

from Dr. Swartz containing three independent ROM measurements for the thumbs and right wrist 

pursuant to FECA Bulletin No. 17-06.

On January 29, 2019 OWCP referred appellant to Dr. Swartz for an impairment evaluation. 

In a report dated February 22, 2019, Dr. Swartz discussed appellant’s complaints of pain 

in the bilateral thumbs, left more than right. On examination he found a positive Tinel’s test in the 

bilateral hands. For the right wrist, Dr. Swartz obtained three ROM measurements with maximum 

measurements for dorsiflexion of 45 degrees, palmar flexion of 80 degrees, radial deviation of 20 

degrees, and ulnar deviation of 30 degrees. For the left wrist, he measured maximum ROM 

measurements for dorsiflexion of 45 degrees, palmar flexion of 80 degrees, radial deviation of 20 

degrees, and ulnar deviation of 30 degrees. For the right thumb, Dr. Swartz obtained three ROM 

measurements of each joint with the maximum measurements for abduction of the CMC joint of 

 

5 Supra note 2.

6 FECA Bulletin No. 17-06 (issued May 8, 2017).
4

50 degrees, adduction of one and a half centimeters, and opposition of eight centimeters. He 

further provided ROM measurements for the metaphalangeal (MP) joint of 30 degrees and the 

interphalangeal (IP) joint of 60 degrees.7 Dr. Swartz provided the maximum ROM measurements 

for the left thumb joints of abduction of the CMC joint of 50 degrees, adduction of two centimeters, 

opposition of eight centimeters, and motion at the MP joint of 45 degrees, and the IP joint of 60 

degrees. He found that appellant had five percent permanent impairment of the right thumb due 

to loss of ROM, or two percent permanent impairment of the right upper extremity. Dr. Swartz 

further found two percent impairment of the left thumb due to loss of ROM. He noted that he had 

also measured ROM of the wrists, but found that the wrists were not part of the current claim.

On September 24, 2019 Dr. Katz noted that appellant had previously received a schedule 

award for 13 percent permanent impairment of the right upper extremity due to a hand/wrist 

condition. For the right thumb, he used Table 15-30 on page 468 of the A.M.A., Guides and found 

that 60 degrees flexion at the IP joint yielded one percent impairment, 30 degrees flexion at the 

MP joint yielded four percent impairment, one and a half centimeters adduction yielded no 

impairment, 50 degrees radial deviation yielded no impairment, and eight centimeters opposition 

yielded no impairment. Dr. Katz further found that extension at the IP and MP joints were within 

normal limits. He added the impairment ratings to find five percent permanent impairment of the 

right thumb or two percent permanent impairment of the right upper extremity. For the left thumb,

Dr. Katz determined that 60 degrees flexion at the IP joint yielded one percent impairment, two 

centimeters adduction yielded no impairment, 50 degrees radial deviation yielded no impairment, 

eight centimeters opposition yielded no impairment and 45 degrees flexion at the MP joint yielded 

one percent impairment, and that extension at the IP joint and MP joint were within normal limits. 

He added the impairments due to loss of ROM to find two percent permanent impairment of the 

left thumb or one percent permanent impairment of the left upper extremity according to Table 15-

12 on page 421 of the A.M.A., Guides. Dr. Katz further found 26 percent permanent impairment 

of the right thumb, or 9 percent permanent impairment of the right upper extremity, and 6 percent 

permanent impairment of the left thumb, for a CMC arthroplasty using the DBI method set forth 

in Table 15-2 on page 394, at the digit regional grid.

By decision dated April 23, 2020, OWCP granted appellant a schedule award for two 

percent permanent impairment of the left thumb. It indicated that, “Overall [r]ight upper extremity 

impairment equals two percent. However, a prior [schedule award] of 13 percent right upper 

extremity was previously issued on December 20, 2016. Therefore, no additional right upper 

schedule award payment is due beyond the previously paid 13 percent.” The decision included 

that the period of the award ran for 1.5 weeks from February 22 to March 4, 2019. 

LEGAL PRECEDENT

The schedule award provisions of FECA,8and its implementing federal regulation,9set 

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

 

7 Dr. Swartz did not indicate whether the measurements were for flexion or extension.

8 Supra note 1.

9 20 C.F.R. § 10.404.
5

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

however, does not specify the manner in which the percentage loss of a member shall be 

determined. The method used in making such a determination is a matter which rests in the 

discretion of OWCP. For consistent results and to ensure equal justice, the Board has authorized 

the use of a single set of tables so that there may be uniform standards applicable to all claimants. 

OWCP evaluates the degree of permanent impairment according to the standards set forth in the 

specified edition of the A.M.A., Guides, published in 2009.10 The Board has approved the use by 

OWCP of the A.M.A., Guides for the purpose of determining the percentage loss of use of a 

member of the body for schedule award purposes.11

The sixth edition of the A.M.A., Guides provides a DBI method of evaluation utilizing the 

World Health Organization’s International Classification of Functioning Disability and Health 

(ICF).12 Under the sixth edition, the evaluator identifies the impairment class of diagnosis (CDX), 

which is then adjusted by grade modifiers based on functional history (GMFH), physical 

examination (GMPE), and clinical studies (GMCS).13 The net adjustment formula is (GMFH -

CDX) + (GMPE - CDX) + (GMCS - CDX).14 Evaluators are directed to provide reasons for their 

impairment choices, including the choices of diagnoses from regional grids and calculations of 

modifier scores.15

ANALYSIS

The Board finds that the case is not in posture for decision.

In rating an impairment due to loss of ROM of the thumbs, Table 15-30 provides that the 

evaluator should obtain flexion and extension measurements for the IP and MCP joints, and 

adduction, radial abduction, and opposition measurements for the CMC joints.16 Dr. Swartz, 

however, did not specify whether he had measured extension for the IP and MCP joints of 

appellant’s thumbs. As his ROM measurements are incomplete, his opinion is insufficient to 

establish the extent of permanent impairment.17

 

10 For decisions issued after May 1, 2009, the sixth edition of the A.M.A., Guides is used. A.M.A., Guides, (6th ed. 

2009); Federal (FECA) Procedure Manual, Part 2 -- Claims, Schedule Award and Permanent Disability Claims, 

Chapter 2.808.5(a) (March 2017); see also id. at Chapter 3.700, Exhibit 1 (January 2010).

11 P.R., Docket No. 19-0022 (issued April 9, 2018); Isidoro Rivera, 12 ECAB 348 (1961).

12 A.M.A., Guides (6th ed. 2009), p.3, section 1.3, International Classification of Functioning, Disability and Health 

(ICF): A Contemporary Model of Disablement.

13 Id. at 494-531.

14 Id. 411.

15 R.R., Docket No. 17-1947 (issued December 19, 2018); R.V., Docket No. 10-1827 (issued April 1, 2011). 

16 A.M.A., Guides at 468, Table 15-30.

17 See J.A., Docket No. 11-0859 (issued October 11, 2011).
6

Additionally, Dr. Swartz found that any impairment of appellant’s right wrist due to motion 

loss should not be included as he did not have an accepted right wrist condition. OWCP, however, 

previously granted him a schedule award for a right wrist impairment. In his September 6, 2016 

impairment evaluation, Dr. Swartz found that appellant had undergone a right hemitrapeziectomy

for osteoarthritis of the right wrist at the scaphotrapezial joint, and was status post arthroplasty of 

the scaphotrapezial joint of the right wrist. On remand OWCP should refer appellant, together 

with a SOAF and case record to a physician in the appropriate field of medicine to determine 

whether appellant’s accepted claim includes a right wrist condition and, if so, the extent of any 

resulting impairment for the wrist and thumbs in accordance with the provisions of the A.M.A., 

Guides.

18

 Following this and such further development as deemed necessary, it should issue a de 

novo decision.

CONCLUSION

The Board finds that the case is not in posture for decision.

ORDER

IT IS HEREBY ORDERED THAT the April 23, 2020 decision of the Office of Workers’

Compensation Programs is set aside and the case is remanded for further proceedings consistent 

with this decision of the Board.

Issued: March 1, 2021

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

 

18 See L.G., Docket No. 07-0090 (issued May 16, 2007).