United States Department of Labor

Employees’ Compensation Appeals Board

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P.P., Appellant

and

DEPARTMENT OF VETERANS AFFAIRS, 

VETERANS ADMINISTRATION MEDICAL 

CENTER, Salisbury, NC, Employer

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Docket No. 21-1163

Issued: March 30, 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

PATRICIA H. FITZGERALD, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On April 16, 2021 appellant filed a timely appeal from a December 14, 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.2

ISSUES

The issues are: (1) whether OWCP has met its burden of proof to terminate appellant’s 

wage-loss compensation and medical benefits, effective December 3, 2020, as she no longer had 

1

5 U.S.C. § 8101 et seq.

2 The Board notes that,following the December 14, 2020 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 

evidence for the first time on appeal. Id.
2

disability or residuals causally related to her accepted February 21, 2006 employment injury; 

(2) whether appellant has established that she had continuing disability or residuals on or after 

December 3, 2020 causally related to her accepted February 21, 2006 employment injury. 

FACTUAL HISTORY

This case has previously been before the Board.3 The facts and circumstances as set forth 

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

follows.

On March 22, 2006 appellant, then a 41-year-old nursing assistant, filed an occupational 

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

due to factors of her federal employment, including pushing, pulling, transporting, and lifting 

patients. She noted that she first became aware of her condition and its relationship to her federal 

employment on February 21, 2006. Appellant underwent a right carpal tunnel release on 

July 12, 2006. OWCP accepted appellant’s claim for bilateral CTS on January 15, 2009.

On July 22, 2020 OWCP referred appellant, along with a statement of accepted facts 

(SOAF) and a series of questions, for a second opinion examination and evaluation with

Dr. Chason Hayes, a Board-certified orthopedic surgeon. It requested that Dr. Hayes evaluate 

whether appellant continued to have residuals or disability due to the accepted February 21, 2006 

employment injury.

In an August 19, 2020 report, Dr. Hayes discussed appellant’s factual and medical history 

and reported his findings on physical examination. He noted that appellant had last undergone an 

electromyogram/nerve conduction velocity (EMG/NCV) study on October 10, 2014, which was 

consistent with severe bilateral peripheral polyneuropathy, probably related to her insulin -

dependent diabetes. On physical examination Dr. Hayes observed that appellant’s wrists had no 

abnormal findings, that her scar was well healed, she had no swelling, and full range of motion. 

He also observed that she was uncooperative with the sensory examination. Dr. Hayes opined that 

appellant’s work-related CTS had resolved following surgery and that she had no residuals. He

further opined that appellant was capable of working her date-of-injury position. Dr. Hayes

explained that appellant had residuals from unrelated medical conditions such as cervical 

radiculopathy and peripheral neuropathy from diabetes, but that, with regard to the accepted work 

condition, there was no medical contraindication to her returning to full-duty employment.

On October 23, 2020 OWCP issued a notice proposing to terminate appellant’s wage-loss 

compensation and medical benefits based on Dr. Hayes’ opinion that the February 21, 2006 

accepted condition had ceased without residuals or disability. It afforded her 30 days to submit 

additional evidence of argument challenging the proposed termination.

In a response dated November 11, 2020, appellant replied to OWCP’s notice of proposed 

termination, stating that she did not understand why her claim was being terminated when she still 

had medical problems. In an attached letter dated March 5, 2020, Dr. Katherine Butler, an 

3 Docket No. 10-1201 (issued January 4, 2011); Docket No. 09-2166 (issued May 12, 2010); Docket No. 07-1559 

(issued November 7, 2007).
3

orthopedic surgeon, opined that appellant had recurrent bilateral CTS, noting that she had 

previously been treated by another physician for bilateral CTS due to repetitive work activities. 

She explained that appellant’s recurrence was likely due to scar tissue formation at the surgical 

site and, therefore, could be considered related to her initial injury. In a letter dated June 24, 2020,

Dr. Butler explained that she had begun seeing appellant as a patient in 2020. She diagnosed 

bilateral carpal tunnel syndrome, noting that it was supported by physical examination, NCV 

studies, and medical reports. Dr. Butler stated that appellant’ssymptoms appeared to be consistent 

and that she had reached maximum medical improvement (MMI). She noted that appellant had 

previously undergone bilateral CTS surgery, but continued to have numbness, burning, pain, and 

weakness in her hands, which prevented her from returning to employment. Dr. Butler opined that 

it was reasonable to assume, based on documentation, that appellant had bilateral CTS attributable 

to work and that she has been persistently unable to return to work due to this injury.

In a letter dated July 15, 2020, Dr. Benjamin Ott, a Board-certified family practitioner, 

opined that appellant had chronic bilateral CTS due to repetitive work activities in her federal 

employment as of February 21, 2006. He explained that her persistent symptoms were likely due 

to scar tissue formation related to previous treatment and that she was permanently disabled from 

all occupations due to this injury.

Appellant also attached a progress report from Dr. William Mason, a Board-certified 

orthopedic surgeon, dated November 29, 2006, in which he opined she was unable to work.

In a note dated November 27, 2020, Dr. Ott indicated that he had seen appellant regularly 

every three to four months since prior to 2011. He noted that he regularly discussed her ongoing 

issues with CTS and nerve damage at her appointments, including in 2019 and 2020.

By decision dated December 2, 2020, OWCP terminated appellant’s wage-loss 

compensation and medical benefits, effective December 3, 2020, based on Dr. Hayes’ second 

opinion report.

On December 10, 2020 appellant requested reconsideration. With her request, she 

submitted an EMG/NCV study dated March 3, 2020.

By decision dated December 14, 2020, OWCP denied modification the of the December 2, 

2020 decision.

LEGAL PRECEDENT -- ISSUE 1

Once OWCP accepts a claim and pays compensation, it has the burden of proof to justify 

termination or modification of an employee’s benefits.4 After it has determined that, an employee 

has disability causally related to his or her federal employment, OWCP may not terminate 

compensation without establishing that the disability has ceased or that it is no longer related to 

4

See R.P., Docket No. 17-1133 (issued January 18, 2018); S.F., 59 ECAB 642 (2008); Kelly Y. Simpson, 57 ECAB 

197 (2005); Paul L. Stewart, 54 ECAB 824 (2003).
4

the employment.5 Its burden of proof includes the necessity of furnishing rationalized medical 

opinion evidence based on a proper factual and medical background.6

The right to medical benefits for an accepted condition is not limited to the period of 

entitlement for disability compensation.7 To terminate authorization for medical treatment, OWCP 

must establish that appellant no longer has residuals of an employment-related condition, which 

require further medical treatment.8

ANALYSIS -- ISSUE 1

The Board finds that OWCP did not meet its burden of proof to terminate appellant’s wageloss compensation and medical benefits, effective December 3, 2020.

In his August 19, 2020 report, Dr. Hayes discussed appellant’s factual and medical history 

and reported the findings of his physical examination. On physical examination of appellant’s 

wrists, he observed normal findings, including that appellant’s scar was well healed, she had no 

swelling, and full range of motion. Dr. Hayes opined that appellant’s work-related CTS had 

resolved after surgery and that she had no residuals. He related that he had reviewed appellant’s 

October 10, 2014 EMG study, which he related was consistent with severe bilateral peripheral 

polyneuropathy. While he opined that this finding was “probably” related to appellant insulindependent diabetes, Dr. Hayes offered no rationale in support of his opinion. His opinion regarding 

the cause of appellant’s severe bilateral peripheral polyneuropathy was speculative in nature. The 

Board has held that speculative and equivocal medical opinions regarding causal relationship have 

no probative value.9 The Board also notes that, while Dr. Hayesfound that the 2014 EMG revealed 

severe bilateral median nerve studies, he did not obtain further diagnostic studies to confirm 

whether appellant’s condition had resolved. Dr. Hayes concludedthat appellant had residuals from 

unrelated medical conditions such as cervical radiculopathy and peripheral neuropathy from 

diabetes, but he offered no medical rationale, supported by objective findings, regarding the cause 

of appellant’s continued residuals. The Board has held that a medical opinion is of limited 

probative value if it contains a conclusion regarding a given medical matter, which is unsupported

by medical rationale.10

5

See R.P., id.; Jason C. Armstrong, 40 ECAB 907 (1989); Charles E. Minnis, 40 ECAB 708 (1989); VivienL. 

Minor, 37 ECAB 541 (1986).

6

See R.P., supra note 4; Del K. Rykert, 40 ECAB 284, 295-96 (1988).

7

See R.P., supra note 4; KathrynE. Demarsh, 56 ECAB 677 (2005); A.P., Docket No. 08-1822 (issued 

August 5, 2009). Furman G. Peake, 41 ECAB 361, 364 (1990).

8

See R.P., supra note 4; James F. Weikel, 54 ECAB 660 (2003); PamelaK. Guesford, 53 ECAB 727 (2002); 

Furman G. Peake, id.

9 M.G., Docket No. 21-0747 (issued October 15, 2021). 

10 See P.C., Docket No. 20-0371 (issued January 26, 2021); L.G., Docket No. 19-0142 (issued August8, 2019);

E.R., Docket No. 15-1046 (issued November 12, 2015); C.M., Docket No. 14-0088 (issued April18, 2014).
5

As Dr. Hayes’ August 19, 2020 report was insufficiently rationalized and of diminished

probative medical value in establishing that appellant’s accepted bilateral carpal tunnel conditions 

had resolved, OWCP improperly determined that it constituted the weight of the medical evidence. 

The Board therefore finds that OWCP did not meet its burden of proof to terminate appellant’s 

compensation benefits.

11

CONCLUSION

The Board finds that OWCP did not meet its burden of proof to terminate appellant’s wageloss compensation and medical benefits, effective December 3, 2020.

ORDER

IT IS HEREBY ORDERED THAT the December 14, 2020 decision of the Office of 

Workers’ Compensation Programs is reversed.

Issued: March 30, 2022

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

11 In light of the Board’s disposition of Issue 1, Issue 2 is rendered moot.