United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

A.A., Appellant

and

DEPARTMENT OF AGRICULTURE, FOOD 

SAFETY & INSPECTION SERVICE, 

Enterprise, AL, Employer

__________________________________________

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Docket No. 21-1113

Issued: January 6, 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 July 15, 2021 appellant, through counsel, filed a timely appeal from a June 17, 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 established right upper extremity cubital tunnel 

syndrome and right middle finger tenosynovitis causally related to the accepted factors of her 

federal employment.

FACTUAL HISTORY

On November 16, 2020 appellant, then a 48-year-old food inspector, filed an occupational 

disease claim (Form CA-2) alleging that she developed a pinched nerve and cubital tunnel 

syndrome in her right hand due to factors of her federal employment, including repetitive use of 

both hands. She reported experiencing hand pain and swelling every time she went to work. 

Appellant reported that she first became aware of her claimed condition on August 27, 2019 and 

of its relation to factors of her federal employment on September 10, 2020. She stopped work on 

September 20, 2020.

3

On September 21, 2020 appellant underwent an electromyogram/nerve conduction 

velocity (EMG/NCV) study of the right upper extremity, which revealed findings consistent with 

a mild ulnar nerve injury at or near the right elbow.

In an October 1, 2020 report, Dr. David H. MacDonald, an osteopath and Board-certified 

orthopedist specializing in hand surgery, reviewed the September 21, 2020 EMG/NCV study and

diagnosed cubital tunnel syndrome of the right upper extremity, tenosynovitis of the right middle 

finger and right hand pain. Appellant was scheduled to undergo a right ulnar nerve neuroplasty 

and A1 pulley release of the right middle finger for October 9, 2020.

In a November 29, 2020 note, Dr. MacDonald diagnosed synovitis and tenosynovitis of the 

right hand. He advised that appellant would need a job she could perform with her left hand as 

she could not use her right hand.

In a development letter dated January 5, 2021, OWCP advised appellant of the factual and

medical deficiencies of her claim. It asked her to complete a questionnaire to provide further 

details regarding the circumstances of her claimed injury and requested a narrative medical report 

from her treating physician, which contained a detailed description of findings and diagnoses, 

explaining how her work activities caused, contributed to, or aggravated her medical condition. In 

a separate development letter of even date, OWCP requested that the employing establishment 

provide comments from a knowledgeable supervisor regarding the accuracy of appellant’s 

allegations. It afforded both parties 30 days to respond.

On January 13, 2021 an employing establishment human resources specialist, responded 

to OWCP’s development questionnaire. In an e-mail of even date, appellant’s supervisor,

3 Appellant also included a statement wherein she reported that on August27, 2019 she originally saw Dr.Orvis 

Chitwood, a Board-certified orthopedist specializing in hand surgery, who diagnosed right hand-acquired trigger 

finger and administered cortisone injections. She related that repetitive motion seemed to be the cause of her injury, 

which she alleged occurred while performing work at the employing establishment. Appellant further stated that only 

her right hand was affected and she had no other similar conditions.
3

concurred with appellant’s allegations. She reported that appellant’s shifts consisted of 

postmortem inspection of between 16,875 and 17,500 poultry carcasses per eight-hour workday. 

The supervisor explained that appellant used a two-handed inspection technique to reflect the 

carcasses’ abdominal flaps, which required down and forward movement of the arms, rotation of 

the wrists, flexion of the thumbs, and some use of the fingers. She noted that appellant occasionally 

had to reach forward 8 to 12 inches from a standing or sitting position in order to inspect viscera. 

The employing establishment also submitted appellant’s job description.

Appellant responded to OWCP’s development questionnaire on January 25, 2021, relating 

that she had to reflect the flaps of a chicken to inspect the cavity 35 times per minute for at least 8 

hours a day. She indicated that this required repeated movement of the hand or wrist and, thus,

she believed it contributed to her medical conditions. Appellant also noted that she was unable to 

open her two middle fingers all the way and that she experienced pain, especially with repeated 

use. Finally, she reported that she sustained a hairline fracture to her right wrist in 2003.

By decision dated February 11, 2021, OWCP denied appellant’s occupational disease 

claim, finding that the evidence of record was insufficient to establish that her medical conditions 

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

On February 23, 2021 appellant, through counsel, requested a telephonic hearing before a 

representative of OWCP’s Branch of Hearings and Review.

OWCP received additional medical evidence including September 9, October 28, and 

December 3, 2020, and January 14, 2021 follow-up reports from Dr. MacDonald. In the 

September 9, 2020 report, he reported that appellant could return to light modified-duty work. On 

October 28, 2020 he released appellant from work for four weeks. Dr. MacDonald further noted,

in the December 3, 2020 and January 14, 2021 reports, that appellant would need to have a job 

that she could safely perform with her left hand because she could not use her right hand. He 

recommended ongoing occupational therapy and prescribed Medrol Dose Pak. Appellant also 

submitted an October 23, 2020 surgery report from Dr. MacDonald, who performed a right elbow 

ulnar neuroplasty and right middle finger A1 pulley release. Dr. MacDonald diagnosed right 

cubital tunnel syndrome and right middle trigger finger.

During a telephonic hearing held before an OWCP hearing representative on May 11, 2021, 

appellant described inspecting around 16,000 poultry carcasses per eight-hour shift with extensive 

upper extremity movement. She testified that, at some point, she began to notice that her right 

hand would freeze into place while inspecting. Appellant also outlined her treatment thereafter 

and testified that her two middle fingers continued to lock, even after surgery. She did not return

to work because Dr. MacDonald advised that she could not use her right hand. The hearing 

representative advised appellant of the type of medical evidence necessary to establish her

occupational disease claim and held the case record open for 30 days for the submission of 

additional evidence. OWCP did not receive any further evidence.

By decision dated June 17, 2021, OWCP’s hearing representative affirmed the 

February 11, 2021 decision.
4

LEGAL PRECEDENT

An employee seeking benefits under FECA 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 period 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 establish that an injury was sustained in the performance of duty in an occupational 

disease claim, a claimant must submit the following: (1) a factual statement identifying 

employment factors alleged to have caused or contributed to the presence or occurrence 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 identified employment factors. 7

Causal relationship is a medical question that requires rationalized medical opinion 

evidence to resolve the issue.8 A physician’s opinion on whether there is causal relationship 

between the diagnosed condition and the implicated employment factor(s) 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 appellant’s 

specific employment factor(s).10

ANALYSIS

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

extremity cubital tunnel syndrome and right middle finger tenosynovitis causally related to the 

accepted factors of her federal employment.

4

S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59 ECAB 178 (2007); 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 K.M., Docket No. 15-1660 (issued September 16, 2016); L.M., Docket No. 13-1402 (issued February 7, 

2014); DeloresC. Ellyett, 41 ECAB 992 (1990).

7 R.G., Docket No. 19-0233 (issued July 16, 2019). See also Roy L. Humphrey, 57 ECAB 238, 241 (2005);Ruby I. 

Fish, 46 ECAB 276, 279 (1994);Victor J. Woodhams, 41 ECAB 345 (1989).

8 T.H., 59 ECAB 388, 393 (2008);Robert G. Morris, 48 ECAB 238 (1996).

9 M.V., Docket No. 18-0884 (issued December 28, 2018).

10 Id.; Victor J. Woodhams,supra note7.
5

In medical notes dated September 9, 2020 through January 14, 2021, Dr. MacDonald

diagnosed right upper extremity cubital tunnel syndrome with middle finger tenosynovitis. 

However, he did not discuss appellant’s accepted work factors or offer an opinion on causal 

relationship. 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.11 

For this reason, Dr. MacDonald’s medical evidence is insufficient to meet appellant’s burden of 

proof.

The remaining medical evidence consisted of a September 21, 2020 EMG/NCV study. The 

Board has held, however, that diagnostic testing reports, standing alone, lack probative value on 

the issue of causal relationship as they do not address the relationship between the accepted 

employment factors and a diagnosed condition.12 For this reason, this evidence is also insufficient 

to meet appellant’s burden of proof.

As appellant has not submitted rationalized medical evidence establishing that her right 

upper extremity cubital tunnel syndrome and right middle finger tenosynovitis are causally related 

to the accepted factors of her federal employment, the Board finds that she has not met her burden 

of proof to establish her claim.

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 right upper 

extremity cubital tunnel syndrome and right middle finger tenosynovitis causally related to the 

accepted factors of her federal employment.

11 S.J., Docket No. 19-0696 (issued August23, 2019); M.C., Docket No. 18-0951 (issued January 7, 2019); L.B., 

Docket No. 18-0533 (issued August27, 2018); D.K., Docket No. 17-1549 (issued July 6, 2018).

12 W.M.,Docket No. 19-1853 (issued May 13, 2020); L.F., Docket No. 19-1905 (issued April10, 2020).
6

ORDER

IT IS HEREBY ORDERED THAT the June 17, 2021 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: January 6, 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