United States Department of Labor

Employees’ Compensation Appeals Board

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T.D., Appellant

and

DEPARTMENT OF THE AIR FORCE, 482ND

CIVIL ENGINEERING SQUADRON, 

HOMESTEAD AIR FORCE BASE, FL, 

Employer

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Docket No. 23-0037

Issued: August 23, 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

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On October 12, 2022 appellant filed a timely appeal from a June 3, 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 accepted factors of his federal employment.

1

5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY

On December 3, 2019 appellant, then a 56-year-old environmental protection specialist, 

filed an occupational disease claim (Form CA-2) alleging that he developed osteoarthritis in both 

hands due to factors of his federal employment including repetitive handling and lifting of heavy 

materials. He noted that he first became aware of his condition on October 16, 2019, and first 

realized its relation to factors of his federal employment on November 8, 2019.

2

 Appellant did not 

stop work.

In support of his claim, appellant submitted additional evidence, including a copy of his 

official position description, a January 6, 2019 notification of personnel action form, and a 

November 11, 2019 statement. He noted that prior to 2011, he had a staff of 10 workers who 

performed all manual labor necessary to process approximately 600 tons of bulk waste each year. 

The staffing program was cancelled in June 2011. From October 2011 through June 2013, 

appellant had three part-time assistants. Thereafter, he had intermittent part-time assistance. 

Appellant experienced the onset of symptoms in his left hand in approximately 2015 and in his 

right hand in 2017. In June 2018, he consulted Dr. Daniel T. Alfonso, a Board-certified orthopedic 

surgeon, who diagnosed severe basal joint arthritis bilaterally. Appellant noted that while on active 

military duty in 2003, he was involved in a motor vehicle accident and sustained a metacarpal 

fracture in his left hand. Dr. Alfonso advised appellant that while the fracture may have 

precipitated arthritis in hisleft hand, his “extreme manual labor” caused severe bilateral basal joint 

osteoarthritis.

In a May 29, 2019 report, Dr. Alfonso noted treating appellant in June 2018 for left 

carpometacarpal (CMC) joint symptoms. On examination, he observed swelling, tenderness, and 

restricted motion of the CMC joint bilaterally. Dr. Alfonso obtained x-rays of the right hand,

which demonstrated severe CMC basal joint arthritis. He diagnosed pain in the left hand, primary 

osteoarthritis of the right hand, and unilateral primary osteoarthritis of the first CMC joint of the 

right hand. Dr. Alfonso also stated an impression of bilateral CMC/basal joint arthritis, with the 

left thumb likely “accelerated by same injury that caused second metacarpal fracture.” He 

administered a cortisone injection.

In an October 16, 2019 report, Dr. Alfonso opined that appellant’s bilateral hand condition 

would worsen over time and that “[a]ctivity under duress” would accelerate his symptoms. He 

restricted lifting to five pounds, with limited writing and keyboarding. 

In a November 22, 2019 attending physician’s report (Form CA-20), Dr. Alfonso noted a 

history of a 2003 motor vehicle accident “causing left second metacarpal fracture,” and concurrent 

or preexisting severe basal joint arthritis. He diagnosed bilateral hand pain and arthritis. 

Dr. Alfonso answered a question by checking a box “Yes” indicating that the diagnosed condition 

was causally related to appellant’s employment. He added that “[r]epetitive motion exacerbated 

arthritis.” Dr. Alfonso found appellant partially disabled from work for the period November 22, 

2 Prior to the present claim, appellant filed a traumatic injury claim (Form CA-1) under OWCP File No. xxxxxx773 

for a dislocated left middle finger. OWCP processed the claim as a short form closure.
3

2019 and continuing. He reiterated that appellant’s arthritis would worsen with time. Dr. Alfonso

limited lifting to five pounds.

In a December 16, 2019 development letter, OWCP informed appellant of the deficiencies 

in his claim. It advised him of the type of medical evidence necessary. In a development letter of 

even date, OWCP requested that the employing establishment provide comments from a 

knowledgeable supervisor on the accuracy of appellant’s statements. It afforded both parties 30 

days to respond. 

In response, L.V., an employing establishment manager, confirmed that appellant’s 

position in the recycling center required “a large degree of manual labor,”including frequent lifting 

and grasping while collecting, unloading, and processing bulk materials. He noted that “manpower 

continually decreased throughout the years” until appellant had been left with only two assistants. 

By decision dated January 31, 2020, OWCPdenied appellant’s occupational disease claim, 

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

between his diagnosed conditions and the accepted factors of his federal employment.

Thereafter, OWCP received a May 29, 2019 work slip by Dr. Alfonso restricting lifting to 

five pounds.

In a March 15, 2020 statement, appellant clarified that he first became aware of his 

condition on May 29, 2019 and first reported the condition to his supervisor on May 30, 2019. He 

provided May 30 and October 16, 2019 e-mails to L.V. noting that a physician had limited lifting 

to five pounds due to osteoarthritis in both hands.

On January 27, 2021 appellant, through his then-counsel, requested reconsideration.

In support of the request, appellant’s then-counsel submitted an October 22, 2020 report

by Dr. David Weiss, an osteopath Board-certified in orthopedic surgery. Dr. Weiss recounted 

appellant’s job duties of collecting, transporting, and processing recyclable materials. On 

examination, he noted tenderness to palpation of the CMC joint, abductor pollicis longus, and 

extensor pollicis brevis bilaterally, positive CMC grind and Finkelstein’s tests bilaterally, resisted 

thumb abduction at 3/5 bilaterally, diminished grip and pinch key strength bilaterally, and a swan 

neck deformity of the right thumb. Dr. Weiss diagnosed cumulative and repetitive trauma 

disorder, occupational right and left wrist syndrome, aggravation of age-related bilateral CMC 

joint arthropathy, and bilateral de Quervain’s tenosynovitis. He opined that appellant’s 

occupational exposure “was the competent producing factor” for his subjective and objective 

findings. Dr. Weiss noted that appellant had reached maximum medical improvement (MMI).

By decision dated April 16, 2021, OWCP denied modification of its prior decision. 

On November 1, 2021 appellant, through his then-counsel, requested reconsideration. 

In support of the request, counsel submitted a February 12, 2021 report by Dr. Weiss, who

noted that appellant’s position as an environmental protection specialist entailed repetitive lifting, 

sorting, and cutting of recyclable materials. Dr. Weiss explained that according to the American 
4

Medical Association, Guides to the Evaluation of Permanent Impairment,

3 prolonged repetitive 

stress and “wear and tear” were occupational risk factors for CMC osteoarthritis, and that there 

was some evidence that repetitive, forceful work was an occupational risk factor for de Quervain’s 

disease. He opined that appellant’s work duties aggravated and accelerated bilateral CMC joint 

arthropathy and caused de Quervain’s tenosynovitis. 

By decision dated January 28, 2022, OWCP denied modification of its prior decision.

On March 14, 2022 appellant, through his then-counsel, requested reconsideration.

In support of the request, appellant’s then-counsel submitted a November 12, 2021 report

by Dr. Weiss, who opined that the 2003 left second metacarpal fracture was unrelated to 

appellant’s severe left CMC joint arthritis and bilateral de Quervain’s tenosynovitis. Dr. Weiss

noted that the May 29, 2019 bilateral hand x-rays obtained by Dr. Alfonso demonstrated severe 

CMC joint arthritis in the right thumb. He explained that regardless of when appellant experienced 

the onset of symptoms, there was “no doubt that wear and tear factors and repetitive stress for long 

periods” were “contributing factors and caused aggravation and acceleration of osteoarthritis.”

Dr. Weiss also opined that appellant’s work duties as an environmental protection specialist 

commencing in 2008, which required repetitive handling activities, would accelerate and aggravate 

bilateral CMC joint arthropathy.

By decision dated June 3, 2022, OWCP denied modification of its prior decision.

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 

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

3 A.M.A., Guides (6th ed. 2009).

4

Supra note 1.

5

See J.K., Docket No. 20-0527 (issued May 24, 2022); J.C., Docket No. 20-0882 (issued June23, 2021); S.B., 

Docket No. 17-1779 (issued February 7, 2018); J.P., 59 ECAB 178 (2007); Joe D. Cameron, 41 ECAB 153 (1989).

6

J.K., id.; J.C., id.; J.M., Docket No. 17-0284 (issued February 7, 2018); R.C., 59 ECAB 427 (2008); James E. 

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

7 R.R., Docket No. 19-0048 (issued April25, 2019); K.M., Docket No. 15-1660 (issued September 16, 2016); L.M., 

Docket No. 13-1402 (issued February 7, 2014); Delores C. Ellyett, 41 ECAB 992 (1990).
5

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 

employment factors identified by the claimant were the proximate cause of the condition for which 

compensation is claimed or, stated differently, medical evidence establishing that the diagnosed 

condition is causally related to the employment factors identified by the claimant. 8

The evidence required to establish causal relationship is rationalized medical opinion 

evidence, based upon a complete factual and medical background, showing a causal relationship 

between the claimed condition and identified factors.9 The opinion of the physician must be based 

on a complete factual and medical background of the claim, 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 specific employment activity or factors identified by the 

claimant.10

In any case where a preexisting condition involving the same part of the body is present 

and the issue of causal relationship, therefore, involves aggravation, acceleration, or precipitation, 

the physician must provide a rationalized medical opinion that differentiates between the effects 

of the work-related injury or disease and the preexisting condition.11

ANALYSIS

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

condition causally related to accepted factors of his federal employment.

Dr. Alfonso, in a May 29, 2019 report, opined that appellant’s left CMC/basal joint arthritis 

was likely accelerated by the 2003 metacarpal fracture. The Board has held that medical opinions

that suggests a condition was likely or possibly caused by work activities are speculative and 

equivocal and have limited probative value.12 Therefore, this report is insufficient to establish 

appellant’s claim. 

In an October 16, 2019 report, Dr. Alfonso noted that activity under duress would 

accelerate the worsening of appellant’s symptoms. Similarly, in a November 22, 2019 Form CA20 report, he indicated that the diagnosed condition was causally related to appellant’s condition. 

8

S.C., Docket No. 18-1242 (issued March 13, 2019); R.H., 59 ECAB 382 (2008).

9 A.M., Docket No. 18-1748 (issued April 4, 2019); T.H., 59 ECAB 388 (2008).

10 C.A., Docket No. 22-0764 (issued November 30, 2022); M.T., Docket No. 20-0184 (issued June 24, 2022); M.V., 

Docket No. 18-0884 (issued December 28, 2018); I.J., 59 ECAB 408 (2008); A.D., 58 ECAB 149 (2006).

11 L.B., Docket No. 20-0462 (issued August 18, 2020).

12 B.B., Docket No. 21-0284 (issued October 5, 2022); J.W., Docket No. 18-0678 (issued March 3, 2020).
6

The Board has held, however, that a medical opinion is of limited probative value if it is conclusory 

in nature.13 Therefore, this report is insufficient to establish appellant’s claim.

Dr. Weiss, in reports dated October 22, 2020 and February 12, 2021, opined that 

appellant’s work duties were competent to cause cumulative trauma disorder, bilateral 

occupational wrist syndrome, aggravation of age-related bilateral CMC joint arthropathy, and 

bilateral de Quervain’s tenosynovitis. In a November 12, 2021 report, he elaborated that wear and 

tear and prolonged repetitive stress while performing the duties of an environmental protection 

specialist aggravated and accelerated appellant’s osteoarthritis and bilateral CMC joint 

arthropathy. Although Dr. Weiss provided consistent support for causal relationship between the 

accepted work factors and bilateral hand and wrist conditions, he did not explain how or why 

appellant’s duties would cause, aggravate, or accelerate the diagnosed conditions. The Board has 

held that generalized statements unsupported by adequate medical rationale explaining the 

pathophysiologic mechanism by which the accepted employment duties caused, aggravated, or 

accelerated the employee’s diagnosed conditions are insufficient to establish causal relationship.14 

As such, Dr. Weiss’ reports are insufficient to meet appellant’s burden of proof.15

As the medical evidence of record is insufficient to establish a medical condition causally 

related to the accepted employment incident, the Board finds that he has not met his burden of 

proof to establish his 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 his burden of proof to establish a medical 

condition causally related to accepted factors of his federal employment.

13 B.B., id., C.M., Docket No. 19-0360 (issued February 25, 2020).

14 L.B., Docket No. 21-0353 (issued May 23, 2022); see S.O., Docket No. 21-0002 (issued April29, 2021); A.P., 

Docket No. 19-0224 (issued July 11, 2019).

15 L.B., id.
7

ORDER

IT IS HEREBY ORDERED THAT the June 3, 2022 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: August 23, 2023

Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board