United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

B.W., Appellant

and

DEPARTMENT OF THE INTERIOR, FISH & 

WILDLIFE SERVICE, NORTH MISSISSIPPI 

REFUGES COMPLEX, Grenada, MS, Employer

__________________________________________

)

)

)

)

)

)

)

)

)

Docket No. 21-0721

Issued: February 14, 2023

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

PATRICIA H. FITZGERALD, Deputy Chief Judge

JANICE B. ASKIN, Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On April 13. 2021 appellant filed a timely appeal from an April 8, 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

1 5 U.S.C. § 8101 et seq.

2 The Board notes that following the April 8, 2021 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 her burden of proof to establish a recurrence of 

disability commencing December 7, 2020, causally related to the accepted September 1, 2003 

employment injury.

FACTUAL HISTORY

On April 12, 2004 appellant, then a 30-year-old office automation assistant, filed an 

occupational disease claim (Form CA-2) alleging that she developed tendinitis in her right wrist 

due to factors of her federal employment, including repetitive typing and writing. She explained 

that the tendons in her right hand would swell and tighten up to her arm and shoulder and she was 

initially diagnosed with tendinitis. Appellant noted that she first became aware of her condition 

on September 1, 2003 and first realized its relation to her federal employment on 

September 8, 2003. She did not stop work. OWCP accepted appellant’s claim for right wrist de 

Quervain’s radial tenosynovitis and carpal tunnel syndrome.

On December 2, 2020 appellant filed a notice of recurrence (Form CA-2a), alleging a 

recurrence of a medical condition on October 1, 2020 causally related to her accepted September 1, 

2003 employment injury. She stopped work on December 7, 2020.

In a note dated December 7, 2020, Dr. Cooper L. Terry, a Board-certified orthopedic 

surgeon, noted that appellant was treated that day and that she was totally disabled from work for 

one month or until she was examined for pain management.

In a December 28, 2020 development letter, OWCP informed appellant of the deficiencies 

of her recurrence claim. It advised her of the type of medical evidence necessary to establish her 

claim and provided a questionnaire for her completion. OWCP afforded appellant 30 days to 

respond.

Appellant completed the development questionnaire on February 9, 2021. She asserted 

that her condition had never improved, her new job title changed, she was assigned extra work,

her job duties continued to require typing and word processing, and she was experiencing 

symptoms of bilateral carpal tunnel syndrome. Appellant requested authorization for hand 

surgery.

On February 2, 2021 appellant underwent additional electromyography (EMG) and nerve 

conduction velocity (NCV) studies which demonstrated median neuropathy at the wrists, right 

greater than left or moderate carpal tunnel syndrome. There was no electrophysiologic evidence 

of an ulnar entrapment in either arm. Appellant also provided March 31, 2010 EMG/NCV studies,

which were consistent with moderate-to-severe right carpal tunnel syndrome and mild-to-moderate 

left carpal tunnel syndrome.

By decision dated February 9, 2021, OWCP denied appellant’s recurrence claim, finding

that the medical evidence of record was insufficient to establish causal relationship between her

claimed disability and the accepted employment injury.

On February 18, 2021 appellant requested reconsideration. She submitted additional 

documentation regarding her current position. Appellant also resubmitted her response to 
3

OWCP’s development questionnaire, and copies of her February 2, 2021 and March 31, 2010 

EMG/NCV studies, which were previously of record.

By decision dated April 8, 2021, OWCP denied modification of its prior 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 that any disability or specific condition for which 

compensation is claimed is causally related to the employment injury.4 Under FECA the term 

disability means incapacity, because of an employment injury, to earn the wages that the employee 

was receiving at the time of 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 become disabled from 

work, and the duration of that disability, are medical issues that must be proven by a preponderance 

of probative and reliable medical opinion evidence.7

A recurrence of disability means an inability to work after an employee has returned to 

work, caused by a spontaneous change in a medical condition which resulted from a previous 

compensable injury or illness and without an intervening injury or new exposure in the work 

environment.8

OWCP’s procedures provide that a recurrence of disability includes a work stoppage 

caused by a spontaneous material change in the medical condition demonstrated by objective 

findings. That change must result from a previous injury or occupational illness rather than an 

intervening injury or new exposure to factors causing the original illness. It does not include a 

condition that results from a new injury, even if it involves the same part of the body previously 

injured.9

An employee who claims a recurrence of disability due to an accepted employment-related 

injury has the burden of proof to establish by the weight of the substantial, reliable, and probative 

evidence that the disability for which he or she claims compensation is causally related to the 

accepted injury. This burden of proof requires that a claimant furnish medical evidence from a 

physician who, on the basis of a complete and accurate factual and medical history, concludes that, 

3 Supra note 1.

4 D.S., Docket No. 20-0638 (issued November 17, 2020); F.H., Docket No. 18-0160 (issued August 23, 2019); 

C.R., Docket No. 18-1805 (issued May 10, 2019); Kathryn Haggerty, 45 ECAB 383 (1994); Elaine Pendleton, 40 

ECAB 1143 (1989).

5 20 C.F.R. § 10.5(f); J.S., Docket No. 19-1035 (issued January 24, 2020).

6 T.W., Docket No. 19-1286 (issued January 13, 2020).

7 S.G., Docket No. 18-1076 (issued April 11, 2019); Fereidoon Kharabi, 52 ECAB 291 (2001).

8 20 C.F.R. §10.5(x); T.J., Docket No. 18-0831 (issued March 23, 2020).

9 Federal (FECA) Procedure Manual, Part 2 -- Claims, Recurrences, Chapter 2.1500.2 (June 2013); F.C., Docket 

No. 18-0334 (issued December 4, 2018).
4

for each period of disability claimed, the disabling condition is causally related to the employment 

injury, and supports that conclusion with medical reasoning.10 Where no such rationale is present, 

the medical evidence is of diminished probative value.11

ANALYSIS

The Board finds that appellant has not met her burden of proof to establish a recurrence of 

disability commencing December 7, 2020, causally related to the accepted September 1, 2003 

employment injury.

In support of her claim, appellant submitted a December 7, 2020 note in which Dr. Terry 

found that she was totally disabled from work for one month or until she was examined for pain 

management. However, Dr. Terry did not provide an opinion on causal relationship between the 

claimed disability and the accepted employment injury. The Board has held that medical evidence 

that does not offer an opinion regarding the cause of an employee’s disability is of no probative 

valueon the issue of causal relationship.12 Therefore, this note is insufficient to establish 

appellant’s recurrence claim.

Appellant also submitted EMG/NCV study reports dated March 31, 2010 and 

February 2, 2021. However, the Board has held that diagnostic studies, standing alone, lack

probative value on the issue of causal relationship as they do not address whether the accepted 

employment injuries resulted in appellant’s claimed disability.

13

As the medical evidence of record is insufficient to establish a recurrence of disability 

commencing December 7, 2020, causally related to her accepted September 1, 2003 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 a recurrence of 

disability commencing December 7, 2020, causally related to the accepted September 1, 2003 

employment injury.

10 J.D., Docket No. 18-0616 (issued January 11, 2019).

11 G.G., Docket No. 18-1788 (issued March 26, 2019).

12 See L.D., Docket No. 20-0894 (issued January 26, 2021); D.K., Docket No. 17-1549 (issued July 6, 2018).

13 O.C., Docket No. 20-0514 (issued October 8, 2020); R.J., Docket No. 19-0179 (issued May 26, 2020).
5

ORDER

IT IS HEREBY ORDERED THAT the April 8, 2021 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: February 14, 2023

Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board