United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

R.I., Appellant

and

U.S. POSTAL SERVICE, OSHKOSH CARRIER 

ANNEX, Madison, WI, Employer

__________________________________________

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Docket No. 20-0913

Issued: September 26, 2022

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 May 24, 2022 appellant filed a timely appeal from a March 16, 2022 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 a medical condition 

causally related to the accepted factors of his federal employment.

1

5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY

This case has been previously before the Board. The facts and circumstances of the case 

as set forth in the Board’s prior decision are incorporated herein by reference.2 The relevant facts 

are as follows.

On June 25, 2020 appellant, then a 65-year-old rural letter carrier, filed an occupational 

disease claim (Form CA-2) alleging that he developed bilateral carpal tunnel syndrome (CTS) 

causing pain and numbness in the thumbs and hands as a result of factors of his federal 

employment, including repetitious motion. He noted that he first became aware of his conditions 

and realized their relationship to his federal employment on March 26, 2018. Appellant did not 

stop work.

In a visit note dated June 5, 2020, Dr. Timothy Bergan, an osteopath Board-certified in 

occupational medicine, diagnosed arthritis of the carpometacarpal joints of both thumbs as 

confirmed by bilateral finger x-ray findings. He opined that the condition was work related and 

that appellant could return to work without restrictions, effective immediately.

In a July 6, 2020 development letter, OWCP informed appellant of the deficiencies of his 

claim. It advised him of the factual and medical evidence necessary to establish his claim and also 

provided a questionnaire for completion. OWCP afforded appellant 30 days to respon d. In the 

same letter, it also informed the employing establishment that if he was treated at an agency 

medical facility for the alleged medical condition, it must provide treatment notes.

Appellant, in a July 13, 2020 response to OWCP’s development questionnaire, indicated

that his work duties included daily sorting of 2,000 to 3,000 letters and flats of magazines, flyers,

and small catalogs into small one-inch-wide openings. He also extracted mail from the case to 

place it into trays. Appellant explained that he sometimes had to force mail in and out of the slots 

because they were filled too tightly and had a narrow opening. He related that these duties were

extremely repetitive and that he believes this caused great wear and tear to his hands and wrists. 

Appellant further noted that, while out on his route, he would open and close hundreds of 

mailboxes repetitively, which was difficult in the winter when the mailboxes were frozen shut. He

stated that he performed all of these activities five to six days per week for 38 years, and an 

employing establishment supervisor, M.B., signed in concurrence. Appellant denied any prior 

similar injuries or engaging in any activities outside of work which would cause his symptoms. 

He noted that the pain had been present for about two years, but decreased when he was off from 

work for a few days.

In a July 15, 2020 visit note, Dr. Bergan diagnosed bilateral thumb pain. He noted that the

cause of appellant’s condition was undetermined, but that appellant could return to work without 

restrictions and would be discharged from care.

By decision dated August 10, 2020, OWCP denied appellant’s claim finding that the 

evidence of record was insufficient to establish that the injury or events occurred as alleged. It 

2 Docket No. 20-1616 (issued February11, 2022).
3

concluded, therefore, that he had not met the requirements to establish an injury as defined by 

FECA.

OWCP continued to receive evidence, including reports of x-rays dated June 5, 2020 for 

unrelated conditions of the left shoulder and left hip, and both thumbs, which were read as normal.

On September 3, 2020 appellant appealed OWCP’sAugust 10, 2020 decision to the Board.

By decision dated February 11, 2022,

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the Board found that the case was not in posture for 

decision. The Board found that appellant had established accepted factors of his federal 

employment. Accordingly, the Board remanded the case to OWCP to review the medical evidence 

of record and, following any further development deemed necessary, issue an appropriate decision.

In a February 14, 2022 development letter, OWCP informed appellant of the deficiencies 

of his claim. It advised him of the medical evidence necessary to establish his claim, including a 

narrative medical report from a treating physician, containing a detailed description of findings 

and a diagnosis, explaining how his work activities caused, contributed to, or aggravated his

medical conditions. OWCP afforded appellant 30 days to respond. 

OWCP thereafter received a July 15, 2020 medical report by Dr. Bergan, who noted that 

appellant related complaints of bilateral wrist pain, which he attributed to his work duties. 

Dr. Bergan performed a physical examination and diagnosed bilateral thumb pain. He opined that 

“it is certainly plausible and likely that this is an overuse injury” that “could represent [CTS], but 

without further diagnostic studies that would be difficult to say.” Dr. Bergan noted that appellant’s 

clinical presentation was not convincing for CTS. 

By decision dated March 16, 2022, OWCP denied appellant’s claim finding that the 

evidence of record was insufficient to establish causal relationship between his diagnosed 

conditions and the accepted employment factors.

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 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,5that 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 

3

Supra note 2.

4

Supra note 1.

5 F.H., Docket No. 18-0869 (issued January 29, 2020); J.P., Docket No. 19-0129 (issued April26, 2019); JoeD. 

Cameron, 41 ECAB 153 (1989). 
4

employment injury.6 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.7

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 o f 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 

Causal relationship is a medical question that requires rationalized medical opinion 

evidence to resolve the issue.9 The opinion of the physician must be based upon 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 factors.10

ANALYSIS

The Board finds that appellant has not met his burden of proof to establish a medical 

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

In support of his claim, appellant submitted a visit note dated June 5, 2020 by Dr. Bergan, 

who diagnosed arthritis of the carpometacarpal joints of both thumbs. Dr. Bergan opined that the 

conditions were work related. Although he opined that appellant’smedical conditions were related 

to his work, he did not explain how the accepted factors in the present claim physiologically caused 

or aggravated the diagnosed conditions. Medical reports that lack a rationalized medical opinion 

regarding causal relationship are of diminished probative value. 11 Therefore, the June 5, 2020 

report of Dr. Bergen is insufficient to meet appellant’s burden of proof.12

In reports dated July 15, 2020, Dr. Bergen diagnosed bilateral thumb pain and noted that 

appellant’s clinical presentation was not convincing for CTS. He opined that it was “plausible”

that appellant had an overuse injury, but that it was “difficult to say” without further diagnostic 

6 L.C., Docket No. 19-1301 (issued January 29, 2020); J.H., Docket No. 18-1637 (issued January 29, 2020); 

James E.Chadden, Sr., 40 ECAB 312 (1988).

7 P.A., Docket No. 18-0559 (issued January 29, 2020); K.M., Docket No. 15-1660 (issued September 16, 2016); 

DeloresC.Ellyett, 41 ECAB 992 (1990).

8 P.L., Docket No. 19-1750 (issued March 26, 2020); R.G., Docket No. 19-0233 (issued July 16, 2019); L.M., 

Docket No. 13-1402 (issued February 7, 2014); DoloresC. Ellyett, id.

9

I.J., Docket No. 19-1343 (issued February 26, 2020); T.H., 59 ECAB 388 (2008); RobertG. Morris, 48 ECAB 

238 (1996).

10 D.C., Docket No. 19-1093 (issued June 25, 2020); see L.B., Docket No. 18-0533 (issued August 27, 2018).

11 See A.C., Docket No. 20-1510 (issued April23, 2021); J.P., Docket No. 20-0381 (issued July 28, 2020); R.L., 

Docket No. 20-0284 (issued June 30, 2020).

12 See J.P., Docket No. 18-0349 (issued December 30, 2019); D.D., 57 ECAB 734 (2006).
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testing. The Board has held that pain is a description of a symptom, not a clear diagnosis of a 

medical condition.13 Moreover, medical opinions that are speculative or equivocal in character are 

of diminished probative value.14 Therefore, this evidence is also insufficient to establish 

appellant’s burden of proof.

OWCP also received reports of x-rays of both thumbs. The Board has held that diagnostic 

reports, standing alone, lack probative value on the issue of causal relationship as they do not 

provide an opinion as to whether the accepted employment factors caused a diagnosed condition.15 

Consequently, these diagnostic reports are also insufficient to establish appellant’s claim.

As appellant has not submitted rationalized medical evidence sufficient to establish a 

medical condition causally related to the accepted employment factors, the Board finds that he has 

not met his 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 his burden of proof to establish a medical 

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

13 D.R., Docket No. 18-1408 (issued March 1, 2019); D.A., Docket No. 18-0783 (issued November 8, 2018).

14 D.B., Docket No. 18-1359 (issued May 14, 2019); Ricky S. Storms, 52 ECAB 349 (2001) (while the opinion of a 

physician supporting causal relationship need not be one of absolute medical certainty, the opinion must not be 

speculative or equivocal. The opinion should be expressed in terms of a reasonable degree of medical certainty).

15 S.W., Docket No. 21-1105 (issued December 17, 2021); W.L., Docket No. 20-1589 (issued August 26, 2021); 

A.P., Docket No. 18-1690 (issued December 12, 2019).
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ORDER

IT IS HEREBY ORDERED THAT the March 16, 2022 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: September 26, 2022

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