United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

Y.W., Appellant

and

U.S. POSTAL SERVICE, DANIEL J. DOFFYN 

POST OFFICE, Chicago, IL, Employer

__________________________________________

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Docket No. 21-1011

Issued: January 12, 2022

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

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 June 23, 2021 appellant filed a timely appeal from a June 10, 2021 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 an upper extremity 

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

FACTUAL HISTORY

On March 26, 2020 appellant, then a 51-year-old city carrier, filed an occupational disease 

claim (Form CA-2) alleging that she developed carpal tunnel syndrome (CTS) as a result of factors 

of her federal employment, including repetitive motions associated with casing mail on a daily 

basis. She noted that she first became aware of her condition on April 18, 2017 and realized its 

relationship to her federal employment on March 10, 2020. Appellant did not stop work.

In an April 15, 2020 development letter, OWCP informed appellant that it had not received 

evidence in support of her claim. It advised her of the type of factual and medical evidence needed 

to establish her claim and requested a narrative medical report from her treating physician 

containing a detailed description of findings and a diagnosis, explaining how her work duties 

caused or aggravated a medical condition. OWCP afforded appellant 30 days to submit the 

necessary evidence.

OWCP thereafter received a report of electromyogram and nerve conduction velocity 

(EMG/NCV) testing dated March 8, 2019, which documented right CTS and ulnar neuropathy at 

the right elbow.

In an April 4, 2019 medical report, Dr. Thomas A. Wiedrich, a Board-certified hand and 

plastic surgeon, indicated that appellant related complaints of numbness and tingling in both hands 

for the past three to four years. He performed a physical examination and noted a positive Tinel’s 

sign on the left and positive Phalen’s and median nerve compression tests bilaterally. Dr. Wiedrich 

reviewed appellant’s EMG/NCV results and diagnosed bilateral CTS. He also noted a diagnosis 

of “cubital tunnel syndrome by EMG only” and discussed proceeding with right carpal tunnel 

surgery.

In an April 8, 2019 note, Dr. Marta A. Dudek, a Board-certified internist, indicated that she 

conducted appellant’s preoperative physical examination. She noted a diagnosis of right CTS and 

an upcoming surgery date of April 16, 2019.

In an April 17, 2019 follow-up note, Dr. Wiedrich noted that he performed right open 

carpal tunnel release on April 16, 2019. He indicated that appellant related an immediate

resolution of her numbness, tingling, and night pain.

Dr. Wiedrich, in a follow-up note dated May 22, 2019, found that appellant was capable of 

full use of the right hand, as tolerated, and could return to work the following week.

By decision dated May 19, 2020, OWCP denied appellant’s claim,finding that the medical 

evidence of record was insufficient to establish that her diagnosed medical conditions were

causally related to the accepted factors of her federal employment.
3

On June 11, 2020 appellant, through counsel, requested a telephone hearing before a 

representative of OWCP’s Branch of Hearings and Review, which was held on 

September 11, 2020.

By decision dated November 12, 2020, OWCP’s hearing representative affirmed OWCP’s 

May 19, 2020 decision.

OWCP thereafter received a November 13, 2020 narrative report by Dr. Leonardo Vargas, 

a Board-certified internist, who indicated that appellant had been under his care since 

September 20, 2017. Dr. Vargas noted that her job duties involved forceful and repetitive flexionextension activities with her hands and wrists while casing mail, including pushing, pulling, 

grabbing, and grasping for many hours per day. He related that appellant’ssymptoms of numbness 

and tingling of both hands had been present for four years and were aggravated by casing and 

carrying mail, and were worse at the end of the workday. Dr. Vargas outlined her EMG/NCV 

testing results, and noted that he referred her to Dr. Wiedrich when her symptoms did not resolve 

with conservative treatment. He indicated that appellant related improvement after the April 2019 

surgery, but that her symptoms had recently returned in both hands. Dr. Vargas ordered updated

EMG/NCV testing, which was completed on October 7, 2020 and showed bilateral CTS and ulnar 

neuropathy. He opined that “this bilateral injury to her upper extremities is more likely than not 

work related” and was consistent with her workplace activities and the chronology of her 

symptoms. Dr. Vargas explained that appellant did not have any of the symptoms prior to working 

for the employing establishment, did not engage in any activities outside of work, which involved 

forceful or repetitive use of her hands, and had no relevant underlying medical conditions.

On March 16, 2021 appellant, through counsel, requested reconsideration.

By decision dated June 10, 2021, OWCP denied modification.

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 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

3

Id.

4 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). 

5 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).

6 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).
4

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 o ccurrence of 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.7

The medical evidence required to establish causal relationship between a claimed specific 

condition and an employment incident is rationalized medical opinion evidence.8 A physician’s

opinion on whether there is causal relationship between the diagnosed condition and the implicated 

employment incident must be based on a complete factual and medical background.9 Additionally, 

the physician’s opinion must be expressed in terms of a reasonable degree of medical certainty and 

must be supported by medical rationale explaining the nature of the relationship between the 

diagnosed condition and the specific employment factors identified by the claimant. 10 

ANALYSIS

The Board finds that appellant has not met her burden of proof to establish an upper 

extremity condition causally related to the accepted factors of her federal employment.

In his November 13, 2020 narrative report, Dr. Vargas described appellant’s repetitive 

employment duties and history of symptoms and treatment. He diagnosed bilateral CTS and ulnar 

neuropathy and opined that “this bilateral injury to her upper extremities is more likely than not 

work related.” Dr. Vargas explained that his determination was consistent with her workplace 

activities and chronology of her symptoms. He failed, however, to explain how the accepted 

factors of appellant’s federal employment either caused or contributed to her diagnosed medical 

conditions. The Board has held that a medical opinion should offer a medically-sound and 

rationalized explanation by the physician of how the specific employment duties physiologically 

caused or aggravated the diagnosed conditions.11 In addition, the fact that a condition manifests 

itself during a period of employment is insufficient to establish causal relationship. Temporal 

relationship alone will not suffice.12 Thus, the Board finds that the November 13, 2020 narrative 

report from Dr. Vargas is insufficient to establish causal relationship.

7 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.

8

S.S., Docket No. 19-0688 (issued January 24, 2020); A.M., Docket No. 18-1748 (issued April24, 2019); RobertG. 

Morris, 48 ECAB 238 (1996).

9 C.F., Docket No. 18-0791 (issued February 26, 2019); Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000).

10 See P.M., Docket No. 18-0287 (issued October 11, 2018); John W. Montoya, 54 ECAB 306 (2003).

11 See R.I., Docket No. 21-0033 (issued May 18, 2021); J.M., Docket No. 17-1002 (issued August22, 2017).

12 Z.S., Docket No. 19-1010 (issued October 1, 2020); S.S., Docket No. 19-0675 (issued August 22, 2019); M.H., 

Docket No. 18-1737 (issued March 13, 2019); DanielO. Vasquez, 57 ECAB 559 (2006).
5

Dr. Wiedrich, in his April 4 and 17, and May 22, 2019 notes, diagnosed bilateral CTS. In 

his April 4, 2019 report, he also diagnosed “cubital tunnel syndrome by EMG only.” Similarly, in 

her April 8, 2019 preoperative physical report, Dr. Dudek noted a diagnosis of right CTS. These

reports, however, do not contain an opinion on causation. The Board has held that medical 

evidence that does not offer an opinion regarding the cause of an employee’s condition is of no 

probative value on the issue of causal relationship.13 Therefore,Drs. Wiedrich and Dudek’s reports 

are also insufficient to establish appellant’s claim.

As the medical evidence of record is insufficient to establish causal relationship between 

appellant’s diagnosed conditions and the accepted factors of her federal employment, she 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 an upper 

extremity condition causally related to the accepted factors of her federal employment.

ORDER

IT IS HEREBY ORDERED THAT the June 10, 2021 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: January 12, 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

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