United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

R.J., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Charlotte, NC, Employer

__________________________________________

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Docket No. 20-0223

Issued: October 22, 2020

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, Deputy Chief Judge

JANICE B. ASKIN, Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On November 6, 2019 appellant, through counsel, filed a timely appeal from a 

September 9, 2019 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.

 

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

ISSUE

The issue is whether appellant has met her burden of proof to establish a left hand and wrist 

conditions causally related to the accepted April 9, 2018 employment incident.

FACTUAL HISTORY

On May 7, 2018 appellant, then a 54-year-old mail carrier, filed a traumatic injury claim 

(Form CA-1) alleging that on April 9, 2018 she felt a pop and noticed swelling in her left hand and 

wrist area when she was trying to lift a bag of fertilizer while in the performance of duty. She

stopped work on April 23, 2018. On the reverse side of the claim form, the employing 

establishment controverted the claim noting that appellant was wearing a brace on her hand prior 

to the date of the alleged injury. 

In an April 24, 2018 report, Dr. Tami Kannan, a Board-certified internist, noted that 

appellant was seen on that date and recommended desk work for four weeks to reduce repetitive 

work with her left wrist. In a May 4, 2018 report, she noted that appellant should be excused from 

work from April 2 to May 7, 2018, to reduce repetitive work with appellant’s left wrist, at which 

time she could return to part-time work.

In reports dated May 7 and 9, 2018, Dr. Charlton McNair, a Board-certified internist,

diagnosed de Quervain’s radial styloid tenosynovitis and recommended that appellant return to 

work on May 7, 2018 with restrictions. 

In a May 18, 2018 development letter, OWCP informed appellant that additional factual 

and medical evidence was necessary to establish her claim. It advised her of the type of factual 

and medical evidence needed and provided a questionnaire for her completion. OWCP afforded 

appellant 30 days to respond. 

An x-ray of appellant’s left wrist, dated May 7, 2018, was interpreted by Dr. William H. 

McCuskey, a Board-certified diagnostic radiologist, as demonstrating normal findings. 

Dr. McNair provided additional reports dated May 16, 21, 25, and 30, 2018. Within those 

reports he diagnosed de Quervain’s radial styloid tenosynovitis and recommended work 

restrictions. 

In a June 5, 2018 statement, appellant reiterated that on April 9, 2018 she injured her left 

hand when she picked up a large bag of fertilizer with both hands. She also indicated that she had

not sustained any other injuries on or off the job since the date of her injury on April 9, 2018. 

Appellant also denied any prior similar disability or symptoms. 

By decision dated June 19, 2018, OWCP denied appellant’s claim finding that she had not 

submitted sufficient evidence to establish causal relationship between her diagnosed conditions 

and the accepted April 9, 2018 employment incident. It noted that there was no medical report 

opining that her diagnosed condition was a direct result of her accepted employment incident. 

OWCP further noted that appellant needed to provide a medical report from her physician 

explaining how the employment incident caused or affected her condition. 
3

On July 12, 2018 appellant requested reconsideration.

In support of her reconsideration request appellant submitted additional medical evidence 

including reports from Dr. McNair dated June 13, 20, and 27 and July 5, 2018. In his July 5, 2018 

report, Dr. McNair diagnosed de Quervain’s tendinitis of the left hand. He indicated that appellant 

was injured when she tried to lift a bag of fertilizer that weighed 50 pounds and that she had denied 

any previous injury or diagnosis to her left hand or arm. Dr. McNair noted that her x-rays were 

negative for any bone involvement. He opined that appellant’s condition was work related and 

explained that the diagnosis of tendinitis is a cumulative result of repetitive trauma with lifting. 

Dr. McNair explained how use of the extensors of the thumb and wrist when lifting was the cause 

of her tendinitis. He concluded by noting that the type of lifting that caused the injury, and 

continues to aggravate the tendinitis, is associated with lifting and grasping at the same time.

OWCP also received physical therapy notes dated from May 30 through June 8, 2018. 

On September 4, 2018 appellant noted that she had requested reconsideration and she 

described her history of medical treatment. She also noted that she had requested that the 

employing establishment provide her with reasonable accommodations. 

In a September 5, 2018 report, Dr. John Gaul, a Board-certified orthopedic surgeon, 

recommended that appellant undergo surgery to repair her diagnosed left hand and wrist 

conditions. In a September 7, 2018 report, he indicated that she was scheduled for surgery on 

September 27, 2018. Dr. Gaul noted that, if light duty was not available, appellant would not be 

able to return to work for four weeks. 

By decision dated October 9, 2018, OWCP denied modification of its prior decision.

On April 9, 2019 appellant, through counsel, requested reconsideration and submitted 

additional medical evidence. 

In a June 28, 2018 report, Dr. Michael L. Dockery, a Board-certified orthopedic surgeon, 

noted that the appellant sustained injury while lifting a heavy bag of fertilizer. He diagnosed left 

wrist pain and de Quervain’s tenosynovitis. Dr. Dockery also found preexisting left thumb 

carpometacarpal joint and degenerative joint disease. In a report dated June 29, 2018, he provided 

appellant with work restrictions. 

In a July 19, 2018 report, Dr. Gaul noted the history of injury included that on April 9, 

2018 appellant was lifting a heavy bag of fertilizer (about 50 pounds) and that she was grasping 

with both hands, palm side down, when she felt a pop in her left hand and had immediate pain and 

swelling that she reported to her supervisor. He noted subluxation of her extensor tendons and 

indicated that he believed that she had a partial retinaculum rupture. Dr. Gaul diagnosed subluxing, 

extensor tendon and de Quervain’s tenosynovitis. He opined that these diagnosed left hand and 

wrist conditions were work related. Dr. Gaul also noted that appellant had some osteoarthritis of 
4

her thumb joint, which he opined was not work related. In a separate report of the same date, he

noted her continuing work restrictions. 

A July 26, 2018 magnetic resonance imaging scan read by Dr. Daniel Uri, a diagnostic 

radiology specialist, revealed a dorsal periscapular ganglion. 

In an August 30, 2018 report, Dr. Gaul diagnosed left wrist de Quervain’s tenosynovitis 

and pain which he attributed to appellant’s work. He explained that the history of injury in which 

she reported the feeling of a “pop” was “compatible with a partial sprain of the periscapular area”

and he noted that this mechanism of injury can also cause a ganglion cyst.

In a September 27, 2018 operative report, Dr. Gaul diagnosed dorsal ganglion cyst of the 

left wrist and de Quervain’s tenosynovitis of the left wrist. 

In an October 11, 2018 report, Dr. Gaul opined “I have explained that [it is] somewhat 

difficult to tell in terms of whether a work-related injury caused this or not.” He also provided 

November 8 and December 20, 2018 reports and noted that appellant accepted a seasonal position

with a private employing establishment and had not returned to the employing establishment. On 

December 20, 2018 Dr. Gaul reported that she could return to work on January 20, 2019 without 

restrictions. 

By decision dated September 9, 2019, OWCP denied modification of the October 9, 2018 

decision.

LEGAL PRECEDENT

An employee seeking benefits under FECA3 has 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 determine if an employee sustained a traumatic injury in the performance of duty, 

OWCP begins with an analysis of whether fact of injury has been established.7 Fact of injury 

 

3

Id.

4 See M.A., Docket No. 19-1551 (issued April 30, 2020); 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 E.M., Docket No. 18-1599 (issued March 7, 2019); T.H., 59 ECAB 388, 393-94 (2008).
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consists of two components that must be considered in conjunction with one another. The first 

component is whether the employee actually experienced the employment incident that allegedly 

occurred.8 The second component is whether the employment incident caused a personal injury.9

Rationalized medical opinion evidence is required to establish causal relationship. The 

opinion of the physician must be based on a complete factual and medical background, 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 incident.10

ANALYSIS

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

In support of her claim appellant submitted a series of narrative medical reports from her 

attending physicians. In his July 5, 2018 report, Dr. McNair diagnosed de Quervain’s tendinitis 

of the left hand. He noted the history of lifting a bag of fertilizer at work and noted no history of 

a prior hand or wrist condition. Dr. McNair noted that appellant’s x-rays were negative for any 

bone involvement and opined that her condition was work related. He explained that her diagnosis 

of tendinitis is one that results from cumulative and repetitive trauma with lifting. Dr. McNair 

further explained and identified that appellant’s use of the extensors of the thumb and wrist when 

lifting was the cause of her tendinitis. He concluded by noting that the type of lifting that caused 

the injury, and continues to aggravate the tendinitis, is lifting and grasping at the same time.

Appellant also submitted supportive medical opinion evidence from Dr. Gaul, who in a 

series of reports generally noted that the diagnosed left upper extremity conditions were work 

related. In his July 19, 2018 report, Dr. Gaul noted the history of injury of lifting a heavy bag of 

fertilizer while grasping with both hands, palm side down, when she felt a pop in her left hand and 

had immediate pain and swelling that she immediately reported to her supervisor. He opined that 

these diagnosed conditions were work related. There is no opposing medical evidence contained 

in the record as presented to the Board.

The Board finds that the reports from Drs. McNair and Gaul, when read together, are 

sufficient to require further development of the medical evidence. Both of these physicians are 

qualified in their field of medicine to render rationalized opinions on the issue of causal 

relationship and they provided a comprehensive understanding of the medical record and case 

history. Dr. McNair’s July 5, 2018 report provides a pathophysiological explanation as to how 

appellant’s accepted employment incident on April 9, 2018 when lifting a heavy bag of fertilizer

resulted in the diagnosed left hand and wrist conditions. He sufficiently explains that the act of 

lifting and grasping simultaneously with the extensors of the thumb resulted in sufficient force to 

cause a pop and the development of tendinitis. The reports of Dr. Gaul supplement this explanation 

provided by Dr. McNair, as he too notes lifting and grasping during the accepted employment 

 

8 L.T., Docket No. 18-1603 (issued February 21, 2019); Elaine Pendleton, 40 ECAB 1143 (1989).

9 B.M., Docket No. 17-0796 (issued July 5, 2018); John J. Carlone, 41 ECAB 354 (1989).

10 Id., see also Dennis M. Mascarenas, 49 ECAB 215 (1997).
6

incident. The Board has long held that it is unnecessary that the evidence of record in a case be so 

conclusive as to suggest causal connection beyond all possible doubt. Rather, the evidence 

required is only that which is necessary to convince the adjudicator that the conclusion drawn is 

rational, sound, and logical.11 Accordingly, the Board finds that the medical opinion of 

Drs. McNair and Gaul are rationalized and logical and are therefore sufficient to require further 

development of appellant’s claim.12

It is well established that, proceedings under FECA are not adversarial in nature and, while 

appellant has the burden of proof to establish entitlement to compensation, OWCP shares 

responsibility in the development of the evidence.13 OWCP has an obligation to see that justice is 

done.14

On remand OWCP shall refer appellant, a statement of accepted facts, and the medical 

record to an appropriate specialist. The chosen physician shall provide a rationalized opinion as 

to whether the diagnosed left hand and wrist conditions are causally related to the accepted April 9, 

2018 employment incident. If the physician opines that the diagnosed conditions are not causally 

related, he or she must explain, with rationale, how or why the causation opinion differs from that 

of Drs. McNair and Gaul. Following this and such other further development as deemed necessary, 

OWCP shall issue a de novo decision on appellant’s claim.

CONCLUSION

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

 

11 W.M., Docket No. 17-1244 (issued November 7, 2017); E.M., Docket No. 11-1106 (issued December 28, 2011);

Kenneth J. Deerman, 34 ECAB 641, 645 (1983) and cases cited therein.

12 J.H., Docket No. 18-1637 (issued January 29, 2020); D.S., Docket No. 17-1359 (issued May 3, 2019); X.V., 

Docket No. 18-1360 (issued April 12, 2019); C.M., Docket No. 17-1977 (issued January 29, 2019); William J. 

Cantrell, 34 ECAB 1223 (1983).

13 See id. See also S.M., Docket No. 19-1634 (issued August 25, 2020); A.P., Docket No. 17-0813 (issued January 3, 

2018); Jimmy A. Hammons, 51 ECAB 219, 223 (1999).

14 See B.C., Docket No. 20-0498 (issued August 27, 2020); B.C., Docket No. 15-1853 (issued January 19, 2016);

E.J., Docket No. 09-1481 (issued February 19, 2010); John J. Carlone, 41 ECAB 354 (1989).
7

ORDER

IT IS HEREBY ORDERED THAT the September 9, 2019 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: October 22, 2020

Washington, DC

Christopher J. Godfrey, 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