United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

S.D., Appellant

and

GENERAL SERVICES ADMINISTRATION, 

Kansas City, MO, Employer

__________________________________________

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Docket No. 21-1047

Issued: July 7, 2022

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

PATRICIA H. FITZGERALD, Deputy Chief Judge

JANICE B. ASKIN, Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On July 1, 2021 appellant filed a timely appeal from a June 24, 2021 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.

2

ISSUE

The issue is whether appellant has met her burden of proof to establish disability from work 

for the periods August 23 through October 22, 2017 and February 12, 2019 through January 17, 

2020 causally related to her accepted July 26, 2017 employment injury. 

1

5 U.S.C. § 8101 et seq.

2 The Board notes that counsel did not appealfrom OWCP’s May26, 2021 decision denying a request to expand 

the acceptance of appellant’s claim to include left fifth trigger finger and resulting authorization for surgery. 

Therefore, that decision is not presently before the Board. See 20 C.F.R. § 501.3.
2

FACTUAL HISTORY

On August 28, 2017 appellant, then a 51-year-old program analyst, filed an occupational 

disease claim (Form CA-2) alleging that she developed carpal tunnel syndrome due to factors of 

her federal employment including daily typing on a computer. She became aware of her condition 

and realized it was causally related to factors of her federal employment on July 26, 2017. 

Appellant stopped work on August 18, 2017.

On August 18, 2017 appellant underwent a magnetic resonance imaging (MRI) scan of the 

right upper extremity, which revealed hyperintense T2 signal of the median nerve consistent with 

carpal tunnel syndrome and a small joint effusion about the proximal carpal row suggesting 

capsulitis.

Appellant was treated by Dr. Salvatore A. Fanto, a Board-certified hand surgeon, who in 

work status reports dated August 21, September 13and 20, and October 11 and 26, 2017,diagnosed 

bilateral wrist pain and advised that appellant was unable to work. In a note dated September 27, 

2017, Dr. Fanto treated appellant for bilateral tingling and numbness in the median nerve 

distribution. Findings on physical examination revealed positive median nerve compression test, 

positive Phalen’s test, and positive Tinel’s sign. Dr. Fanto noted appellant’s work duties included 

keyboarding all day for many years.

An electromyogram/nerve conduction velocity (EMG/NCV) study dated October 6, 2017 

revealed evidence of mild bilateral and median neuropathies at the wrists and no evidence of 

cervical radiculopathy, myopathy, or diffuse peripheral neuropathy.

Dr. Fanto evaluated appellant on October 19, 2017 and noted that an MRI scan of the wrist 

revealed compression of the median nerve in the carpal tunnel and that an NCV study confirmed

carpal tunnel syndrome. He noted appellant’s work consisted of years of repetitive motion that 

caused her condition and recommended surgical intervention. On March 13, 2018 Dr. Fanto 

performed right carpal tunnel release, excision of soft tissue mass, tenolysis of flexor tendons, and 

debridement and repair of the flexor pollicis longus tendon. He diagnosed right carpal tunnel 

syndrome and pain.

On August 15, 2018 Dr. Fanto noted that appellant could perform office work.3

On October 19, 2018 Dr. Martin G. Luken, III, a Board-certified neurosurgeon, evaluated 

appellant for persistent disabling symptoms after right carpal tunnel release on March 13, 2018. 

He noted that appellant’s symptoms kept her off work from July 2017 through September 2018.

3 On September 19, 2018 Dr.Dorothy M. Jones, a Board-certified internist, requested reasonable workplace 

accommodations on behalf of appellant. She diagnosed bilateral carpal tunnel syndrome status post right carpal tunnel 

release on March 13, 2018. Dr.Jones indicated that appellant reached maximum medical improvement (MMI), but 

continued to experience bilateral hand pain. She recommended ergonomic workstation, typing limited to 30 minutes 

with 10-minute breaks, and lifting limited to 10 pounds. Dr.Jones concluded that appellant was “unable to reasonably 

perform her duties with the accommodations in place” and that she should “be placed on permanent medical 

disability.”
3

An October 31, 2018 MRI scan of the right upper extremity revealed an enlarged median 

nerve through the carpal tunnel with increased signal and slight anterior bowing in the flexor 

retinaculum.

An EMG/NCV study performed November 7, 2018 revealed evidence of mild bilateral 

median mononeuropathies across the bilateral wrists.

Appellant was evaluated by Dr. Neil Allen, a Board-certified neurologist, on 

November 13, 2018. He diagnosed bilateral carpal tunnel syndrome. Dr. Allen opined that 

appellant’s bilateral carpal tunnel syndrome was related to performing repetitive work duties.

By decision dated January 30, 2019, OWCP accepted appellant’s claim for carpal tunnel 

syndrome of the right and left upper limb.

OWCP received additional evidence. In work status notes dated August 31, December 20, 

2017 and January 24, 2018, Dr. Fanto diagnosed bilateral wrist pain and noted that appellant could 

not work. On November 29, 2017 he diagnosed mild carpal tunnel syndrome and returned 

appellant to restricted duty with no typing, pushing, or pulling. On August 22, 2018 Dr. Fanto 

released appellant to regular duties. He noted treating appellant again on October 3, 2018.

On October 6, 2017 Dr. Howard Robinson, a Board-certified physiatrist, performed an 

EMG/NCV study that revealed evidence of mild bilateral median neuropathies at the wrist. He 

diagnosed cervicalgia, low back pain, and bilateral carpal tunnel syndrome. Dr. Robinson 

recommended bilateral carpal tunnel splints. 

In a Family and Medical Leave Act (FMLA) medical form dated October 24, 2017,

Dr. Jones diagnosed bilateral carpal tunnel syndrome, fibromyalgia, and lupus. She noted that 

appellant was unable to perform her job functions and would be incapacitated from July 26, 2017 

through February 1, 2018. In an undated letter, Dr. Jones noted that appellant had been off work 

since August 22, 2017 and remained severely impaired secondary to bilateral carpal tunnel 

syndrome. Appellant reported bilateral hand pain daily and difficulty performing her activities of 

daily living. Dr. Jones advised that appellant was unable to type or work on a computer due to her 

impairment and indicated that a return to work at this time would worsen her condition. She 

reported her estimated release to return to work was July 1, 2018 with restrictions.

On February 11, 2019 appellant filed claims for compensation (Form CA-7) for disability 

from work during the periods October 23, 2017 through August 26, 2018 and August 28, 2018

through February 11, 2019.

In a March 26, 2019 development letter, OWCP informed appellant of the deficiencies of 

her claim. It advised her of the type of additional factual and medical evidence required and 

afforded her 30 days to submit the requested evidence. No response was received.

By decision dated May 9, 2019, OWCP denied appellant’s claims for wage-loss 

compensation, finding that she had not established disability from work during the period 

October 23, 2017 through February 11, 2019 causally related to the accepted July 26, 2017 

employment injury.
4

On May 16, 2019 appellant, through counsel, requested an oral hearing before a 

representative of OWCP’s Branch of Hearings and Review. A hearing was held on 

August 28, 2019.

On July 31, 2019 Dr. Jennifer M. Wolf, a Board-certified orthopedist, treated appellant for 

persistent bilateral carpal tunnel syndrome with an overlay of complex regional pain syndrome

(CRPS). Appellant reported undergoing a brachial plexus block and stellate ganglion block that

provided some relief in symptoms. Findings on examination of the upper extremities revealed 

intact sensation bilaterally, positive Phalen’s test, Tinel’s sign, and carpal tunnel compression 

testing on the right and tenderness over the fifth A1 pulley on the left with visible locking and 

clicking. Dr. Wolf diagnosed bilateral carpal tunnel syndrome, worse on the right, with an overlay 

of active CRPS, left small finger trigger digit and possible pronator syndrome and performed a left 

trigger finger injection.

By decision dated October 8, 2019, OWCP’s hearing representative denied appellant’s 

claims for wage-loss compensation in part, finding that she had not established disability from 

work for the period October 23, 2017 through March 12, 2018 causally related to the accepted 

July 26, 2017 employment injury and remanded the case for further development with regard to 

wage-loss compensation for the period March 13, 2018 through February 11, 2019.

OWCP received additional evidence. On March 18, 2019 Dr. Magdalena Anitescu, a 

Board-certified anesthesiologist, diagnosed neuropathic pain and performed a right supraclavicular 

nerve block with ultrasound guidance.

In reports dated October 17 and 18, 2019, Dr. Ralph W. Richter, Jr., a Board-certified 

orthopedist, treated appellant for bilateral carpal tunnel syndrome. He noted that appellant had 

right carpal tunnel release on March 13, 2018. Appellant reported not working since 

November 2018. Findings on examination revealed diffuse pain throughout both upper 

extremities, occasional numbness and tingling in both hands, negative Tinel’ssign over the median 

nerve bilaterally, negative Phalen’s test bilaterally, negative median nerve compression test 

bilaterally, no thenar atrophy, and no evidence of pronator syndrome bilaterally. Dr. Richter 

opined that appellant had no evidence of carpal tunnel syndrome in either hand. He diagnosed 

bilateral hand pain and advised that appellant had reached MMI with regard to bilateral carpal 

tunnel syndrome and required no further treatment. Dr. Richter opined that the symptoms she 

experienced in both extremities were related to nonwork-related conditions of fibromyalgia and 

lupus.

By development letters dated October 22 and December 5, 2019, OWCP requested that the 

employing establishment provide the date appellant returned to work after the March 13, 2018 

surgery, a copy of the light-duty job offer or description of duties, and an explanation for 

appellant’s separation. No response was received.

On January 13, 2020 OWCP indicated that the employing establishment failed to respond 

to the October 22 or December 5, 2019 development letters or provide information regarding a 

light-duty job or return to work following the March 13, 2018 surgery. It processed a payment for 

total disability for the period March 13, 2018 through February 11, 2019.
5

On January 19, 2020 appellant filed CA-7 forms for disability from work for the periods

October 23, 2017 through March 10, 2018 and February 12, 2019 through January 17, 2020.

OWCP received additional evidence. A notification of personnel action, Standard Form 

(SF)50 dated November 19, 2018 indicated that appellant was removed from federal employment 

effective November 15, 2018 due to a charge of absent without leave (AWOL).

On November 20, 2019 Dr. Wolf treated appellant for left trigger finger and clicking and 

locking in her left small finger. She noted findings of intact sensation bilaterally, positive Phalen’s 

test bilaterally, positive Tinel’s sign bilaterally, positive carpal tunnel compression test bilaterally, 

and tenderness over the A1 pulley of the fifth finger on the left hand. Dr. Wolf diagnosed recurrent 

and persistent bilateral carpal tunnel syndrome, active CRPS, and left small finger trigger. She 

recommended small trigger finger release and left carpal tunnel release. 

On January 27, 2020 appellantresubmitted previously filed CA-7 formsfor disability from 

work for the period August 23 through October 22, 2017.

In a development letter dated February 12, 2020, OWCP informed appellant of the 

deficiencies of her claim. It advised her of the type of additional evidence required and afforded 

her 30 days to submit the requested evidence.

By decision dated March 12, 2020, OWCP denied appellant’s claims for wage-loss 

compensation, finding that she had not established disability from work for the period February 12, 

2019 through January 17, 2020 causally related to the accepted July 26, 2017 employment injury.

On March 17, 2020 appellant requested an oral hearing before a representative of OWCP’s 

Branch of Hearings and Review with regard to the March 12, 2020 decision forthe denial of wageloss compensation during the period February 12, 2019 through January 17, 2020.

By decision dated March 19, 2020, OWCP denied appellant’s claims for wage-loss 

compensation, finding that she had not established disability from work from August 23 through 

October 22, 2017 causally related to the accepted July 26, 2017 employment injury.

On March 24, 2020 appellant requested an oral hearing from the March 19, 2020 decision 

before a representative of OWCP’s Branch of Hearings and Review. The hearing was held on 

July 9, 2020 and the hearing representative reviewed both the March 12 and 19, 2020 OWCP

decisions.

By decision dated September 22, 2020, OWCP’s hearing representative affirmed the 

March 12 and 19, 2020 decisions, finding that appellant had not established disability from work 

for the periods August 23 through October 22, 2017 and February 12, 2019 through January 17, 

2020 causally related to the accepted July 26, 2017 employment injury.

OWCP received additional evidence. On November 20, 2019 Dr. Wolf treated appellant 

in follow up for left trigger finger, clicking and locking in her left small finger, and numbness and 

tingling in both hands. She noted positive findings on examination and diagnosed recurrent or 

persistent carpal tunnel syndrome, overlay of active CRPS, and left small trigger finger. Dr. Wolf

recommended left carpal tunnel release and small trigger finger release.
6

Appellant was treated by Dr. Sarah T. Yang, a Board-certified physiatrist, on December 14

and 28, 2020, who diagnosed bilateral hand pain and bilateral carpal tunnel syndrome. Dr. Yang

performed a right carpal tunnel hydrodissection ultrasound guided injection. On February 8, 2021

she completed a carpal tunnel residual function capacity questionnaire and reported reduced grip 

strength, tenderness, and decreased sensation in digits one through five bilaterally. Dr. Yang

diagnosed bilateral carpal tunnel syndrome and noted appellant’s impairment would last at least 

12 months.

Dr. Allen evaluated appellant on January 11, 2021 and diagnosed trigger finger, left little 

finger. He opined that appellant’s digital stenosing tenosynovitis of her left little finger was related 

to repetitive and prolonged work duties.

On March 26, 2021 appellant requested reconsideration of the September 22, 2020

decision.

By decision dated June 24, 2021, OWCP denied modification of the September 22, 2020

decision.

LEGAL PRECEDENT

An employee seeking benefits under FECA4 has the burden of proof to establish the 

essential elements of his or her claim, including that any disability or specific condition for which 

compensation is claimed is causally related to the employment injury. 5 For each period of 

disability claimed, the employee has the burden of proof to establish that he or she was disabled 

from work as a result of the accepted employment injury.6 Whether a particular injury causes an 

employee to be disabled from employment and the duration of that disability are medical issues, 

which must be proven by a preponderance of the reliable, probative, and substantial medical 

evidence.7 Findings on examination are generally needed to support a physician’s opinion that an 

employee is disabled from work.8

The term “disability” is defined as the incapacity, because of an employment injury, to earn 

the wages the employee was receiving at the time of the injury. 9 Disability is, thus, not 

synonymous with physical impairment, which may or may not result in an incapacity to earn 

wages.10 An employee who has a physical impairment causally related to a federal employment 

4

5 U.S.C. § 8101 et seq.

5 M.C., Docket No. 18-0919 (issued October 18, 2018); Kathryn Haggerty, 45 ECAB 383 (1994); Elaine Pendleton, 

40 ECAB 1143 (1989).

6

Id.; WilliamA. Archer, 55 ECAB 674 (2004).

7 V.H., Docket No. 18-1282 (issued April2, 2019); Amelia S. Jefferson, 57 ECAB 183 (2005).

8 Dean E. Pierce, 40 ECAB 1249 (1989).

9

20 C.F.R. § 10.5(f); S.T.,Docket No. 18-0412 (issued October 22, 2018); Cheryl L. Decavitch, 50 ECAB 

397 (1999).

10 G.T., Docket No. 18-1369 (issued March 13, 2019); Robert L. Kaaumoana, 54 ECAB 150 (2002).
7

injury, but who nevertheless has the capacity to earn the wages he or she was receiving at the time 

of injury, has no disability as that term is used in FECA.11

The Board will not require OWCP to pay compensation for disability in the absence of any 

medical evidence addressing the specific dates of disability for which compensation is claimed. 

To do so would essentially allow an employee to self-certify his or her disability and entitlement 

to compensation.12

Where employment is terminated, disability benefits would be payable if the evidence of 

record established that the claimant was terminated due to injury-related physical inability to 

perform assigned duties, or the medical evidence of record established that the claimant was unable 

to work due to an injury-related disabling condition.13

ANALYSIS

The Board finds that appellant has not met her burden of proof to establish disability from 

work for the periods August 23 through October 22, 2017 and February 12, 2019 through 

January 17, 2020 causally related to the accepted July 26, 2017 employment injury. 

During her claimed period of disability, appellant received medical treatment from

Dr. Fanto. In work status reports dated August 21, September 13 and 20, October 11 and 26, 

December 20, 2017 and January 24, 2018, Dr. Fanto diagnosed bilateral wrist pain and advised 

that appellant was unable to work. However, Dr. Fanto did not provide an opinion on causal 

relationship. The Board has held that reports that do not provide an opinion on causal relationship 

are of no probative value.14 Thus, these reports are insufficient to establish appellant’s claim for 

compensation.

In a letter dated September 27, 2017 and a report dated October 19, 2017, Dr. Fanto 

diagnosed carpal tunnel syndrome and on March 13, 2018 performed a right carpal tunnel release. 

In reports dated November 13, 2018 and January 11, 2021, Dr. Allen diagnosed bilateral carpal 

tunnel syndrome and trigger finger. He opined that appellant’s bilateral carpal tunnel syndrome 

and digital stenosing tenosynovitis were related to repetitive and prolonged work duties. Similarly, 

in reports dated December 14 and 28, 2020, Dr. Yang diagnosed bilateral hand pain and bilateral 

carpal tunnel syndrome and performed a right carpal tunnel injection. Likewise, on July 31, 2019,

Dr. Wolf treated appellant for persistent bilateral carpal tunnel syndrome, CRPS, and left small 

finger trigger digit. However, Drs. Fanto, Allen, Yang, and Wolf did not specifically address the 

11 See 20 C.F.R. § 10.5(f); N.M., Docket No. 18-0939 (issued December 6, 2018).

12 See B.K., Docket No. 18-0386 (issued September 14, 2018); AmeliaS. Jefferson, supra note 7; see also C.S., 

Docket No. 17-1686 (issued February 5, 2019).

13 S.S., Docket No. 18-1680 (issued March 4, 2019); S.J., Docket No. 17-0783 (issued April9, 2018).

14 See L.B., Docket No. 18-0533 (issued August 27, 2018); D.K.,Docket No. 17-1549 (issued July 6, 2018).
8

relevant issue of disability during the claimed periods and, thus, these reports are of no probative 

value.15

On October 6, 2017 Dr. Robinson diagnosed cervicalgia, low back pain, and bilateral 

carpal tunnel syndrome. Similarly, March 18, 2019, Dr. Anitescu diagnosed neuropathic pain.

Likewise, in a report dated November 20, 2019,Dr. Wolf treated appellant for symptoms of CRPS, 

trigger finger of the left-hand pinky, recurrent or persistent carpal tunnel syndrome. She diagnosed 

pronator syndrome, trigger finger, and CRPS. Appellant was treated by Dr. Richter on October 17 

and 18, 2019, who diagnosed bilateral hand pain related to fibromyalgia and lupus. However, the 

reports of Drs. Robinson, Anitescu, Wolf, and Richter do not provide an opinion on appellant’s 

disability from work during the claimed period and, thus, these reports are of no probative value.16 

Therefore, the reports of Drs. Robinson, Anitescu, Wolf, and Richter are insufficient to establish 

appellant’s claim.

In an FMLA medical form dated October 24, 2017, Dr. Jones diagnosed bilateral carpal 

tunnel syndrome, fibromyalgia, and lupus. She noted that appellant was unable to perform her job 

functions and would be incapacitated from August 21, 2017 through February 1, 2018. In an 

undated note, Dr. Jones indicated that appellant was off work since August 22, 2017 and remained 

severely impaired secondary to her bilateral carpal tunnel syndrome and right carpal tunnel release 

surgery. On October 19, 2018 appellant was evaluated by Dr. Luken for persistent disabling 

symptoms after right carpal tunnel release on March 13, 2018, which kept her off work from 

July 2017 through September 2018. While Drs. Jones and Luken provided affirmative opinions 

that supported causal relationship, they did not offer a rationalized medical explanation in any of 

these reports to support their opinion. Medical evidence that provides a conclusion, but does not 

offer a rationalized medical explanation regarding the cause of an employee ’s condition or 

disability is of limited probative value on the issue of causal relationship.17 Thus, these reports are 

insufficient to establish appellant’s claim. 

On November 29, 2017 and August 15, 2018 Dr. Fanto diagnosed mild carpal tunnel 

syndrome and returned appellant to restricted duty. On August 22, 2018 he released her to regular 

duties. Similarly, on September 19, 2018, Dr. Jones diagnosed bilateral carpal tunnel syndrome 

status post right carpal tunnel release and released appellant to restricted duty. On February 8, 

2021 appellant was evaluated by Dr. Yang who diagnosed bilateral carpal tunnel syndrome and 

provided work restrictions. However, these reports are of no probative value because the 

physicians did not provide an opinion that appellant was disabled from work during the claimed 

period, from August 23 through October 22, 2017 and February 12, 2019 through January 17, 

2020, causally related to the accepted July 26, 2017 bilateral carpal tunnel syndrome.18 Therefore, 

these reports are also insufficient to establish her claim. 

15 Id. 

16 Id.

17 C.V., Docket No. 18-1106 (issued March 20, 2019); M.E., Docket No. 18-0330 (issued September 14, 2018); 

A.D., 58 ECAB 149 (2006).

18 Supra note 12.
9

Finally, appellant submitted results from diagnostic testing. The Board has held, however, 

that diagnostic studies, standing alone, lack probative value as they do not address whether the 

employment injury caused appellant to be disabled during the claimed period.19 These reports are,

therefore, insufficient to establish the claim.

As the medical evidence of record does not contain rationale sufficient to establish 

disability from work for the periods August 23 through October 22, 2017 and February 12, 2019 

through January 17, 2020 causally related to the accepted July 26, 2017 employment injury, the 

Board finds that appellant has not met her burden of proof.

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 disability from 

work for the periods August 23 through October 22, 2017 and February 12, 2019 through 

January 17, 2020 causally related to her accepted July 26, 2017 employment injury. 

19 A.P., Docket No. 21-0300 (issued April6, 2022); see also J.S.,Docket No. 17-1039 (issued October 6, 2017).
10

ORDER

IT IS HEREBY ORDERED THAT the June 24, 2021 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: July 7, 2022

Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board