United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

M.C., Appellant

and

DEPARTMENT OF THE NAVY, NAVAL 

FACILITIES ENGINEERING SYSTEMS 

COMMAND, Norfolk, VA, Employer

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Docket No. 23-0130

Issued: July 17, 2023

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

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 November 7, 2022 appellant, through counsel, filed a timely appeal from an 

October 25, 2022 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 his burden of proof to establish greater than five 

percent permanent impairment of the left thumb, for which he previously received a schedule 

award.

FACTUAL HISTORY

On October 2, 2019 appellant, then a 39-year-old carpenter, filed a traumatic injury claim 

(Form CA-1) alleging that on September 23, 2019 he cut his left thumb down to the bone when 

cutting carpet with a razor knife while in the performance of duty. He did not stop work. OWCP 

accepted the claim for a displaced fracture of the distal phalanx of the left thumb. On 

September 25, 2019 appellant underwent an OWCP-authorized debridement of an open fracture 

of the left thumb distal phalanx with nail bed and wound repair. On October 11, 2019 he 

underwent an incision and drainage of a wound infection of the left thumb.

On October 1, 2020 appellant filed a claim for compensation (Form CA-7) for a schedule 

award.

In an impairment evaluation dated October 6, 2020, Dr. Neil Allen, a Board-certified 

internist and neurologist, discussed appellant’s current symptoms of pain, numbness, and tingling 

in the left thumb with reduced flexion. On examination he found full muscle strength, tenderness 

of the distal proximal interphalangeal (PIP) joint, and reduced sensation of the distal phalanx of 

the left thumb. Dr. Allen measured range of motion (ROM) of the left wrist three times, finding a 

maximum flexion of 75 degrees, extension of 81 degrees, radial deviation of 31 degrees, and ulnar 

deviation of 45 degrees.3 He further measured ROM of the right and left thumbs. Dr. Allen 

provided three measurements for the left thumb. He found a maximum flexion of the

interphalangeal (IP) joint of 75 degrees, extension of the IP joint of 11 degrees, flexion of the 

metacarpophalangeal (MCP) joint of 63 degrees, extension of the MCP joint of 15 degrees, 

abduction of the carpometacarpal (CMC) joint of 2 centimeters, radial abduction of the CMC joint 

of 97 degrees, and opposition of the CMC joint of 6.5 centimeters. 4 Using the diagnosis-based 

impairment (DBI) method, Dr. Allen identified the class of diagnosis (CDX) as 1 for a distal 

phalanx fracture according to Table 15-2 on page 393 of the sixth edition of the American Medical 

Association, Guides to the Evaluation of Permanent Impairment (A.M.A., Guides).5 He reviewed 

x-rays of the left hand from September 25, 2019 showing a fracture through the ulnar distal tip of 

the distal phalanx of the thumb. Dr. Allen applied a grade modifier for functional history (GMFH) 

of two based on appellant’s QuickDASH score of 36 and a grade modifier for physical examination 

(GMPE) of one due to mild loss of motion of one percent and mild palpatory findings. He found 

that a grade modifier for clinical studies (GMCS) was not applicable as it was used in class 

placement. Dr. Allen applied the net adjustment formula to find an increase of one place from the 

3 The ROM measurements of the left wrist yielded no impairment pursuant to Table 15-32 on page 473.

4 Under Table 15-30 on page 468, 75 degrees flexion of the IP joint yielded 1 percent impairment. The remaining 

ROM measurements yielded no impairment. The ROM measurement for appellant’s unaffected right thumb also 

yielded a one percent impairment of the IP joint due to loss of flexion.

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

default value of four percent, for a total impairment of the digit of five percent. He converted the 

five percent impairment of the digit to two percent impairment of the upper extremity using Table 

15-12 on page 421 of the A.M.A., Guides.

OWCP referred the case record, along with a statement of accepted facts to a district 

medical adviser (DMA) for an opinion regarding appellant’s schedule award claim. On May 3, 

2021 Dr. Nathan Hammel, a Board-certified orthopedic surgeon serving as the DMA, found that 

appellant had no impairment using the ROM method as his ROM was symmetrical on both sides. 

He concurred with Dr. Allen’s finding of five percent permanent impairment of the left thumb

using the DBI method. Dr. Hammel found that appellant had reached maximum medical 

improvement (MMI) on October 6, 2020.

By decision dated August 12, 2021, OWCP granted appellant a schedule award for five 

percent permanent impairment of the left digit/thumb. The period of the award ran for 3.75 weeks 

from October 6 to November 1, 2020.

On August 18, 2021 appellant, through counsel, requested a telephonic hearing before a 

representative of OWCP’s Branch of Hearings and Review.

A telephonic hearing was held on December 8, 2021. Counsel contended that appellant’s 

impairment to the thumb, an oppositional digit, affected his entire arm. She maintained that he 

was entitled to an award for two percent permanent impairment of the upper extremity instead of 

five percent permanent impairment of the thumb.

By decision dated February 22, 2022, OWCP’s hearing representative set aside the 

August 12, 2021 decision. She remanded the case for the DMA to explain whether the five percent 

permanent impairment of the thumb should be converted to two percent permanent impairment of 

the left upper extremity.

On April 6, 2022 Dr. Hammel again found five percent permanent impairment of the left 

thumb. He discussed appellant’s complaints of numbness and tingling in the left thumb with mild 

motion loss and full strength. Dr. Hammel opined that the A.M.A., Guides at 390 provided that a 

digit impairment should remain a digit impairment absent the involvement of multiple digits, and 

that a digit impairment was only changed to an upper extremity impairment if required prior to 

conversion to whole person impairment. 

By decision dated April 20, 2022, OWCP denied appellant’s claim for an increased 

schedule award, finding that he had no more than the five percent permanent impairment of the 

left thumb previously awarded. 

On April 26, 2022 appellant, through counsel, requested a telephonic hearing before a 

representative of OWCP’s Branch of Hearings and Review. 

A hearing was held on August 8, 2022. 

By decision dated October 25, 2022, OWCP’s hearing representative affirmed the 

April 20, 2022 decision. 
4

LEGAL PRECEDENT

The schedule award provisions of FECA,6 and its implementing federal regulation,7 set 

forth the number of weeks of compensation payable to employees sustaining permanent 

impairment from loss, or loss of use, of scheduled members or functions of the body. FECA, 

however, does not specify the manner in which the percentage loss of a memb er shall be 

determined. The method used in making such a determination is a matter which rests in the 

discretion of OWCP. For consistent results and to ensure equal justice, the Board has authorized 

the use of a single set of tables so that there may be uniform standards applicable to all claimants. 

OWCP evaluates the degree of permanent impairment according to the standards set forth in the 

specified edition of the A.M.A., Guides, published in 2009.8 The Board has approved the use by 

OWCP of the A.M.A., Guides for the purpose of determining the percentage loss of use of a 

member of the body for schedule award purposes.9

In addressing upper extremity impairments, the sixth edition of the A.M.A., Guides

requires identification of the impairment CDX condition, which is then adjusted by a GMFH, 

GMPE, and GMCS.10 The net adjustment formula is (GMFH - CDX) + (GMPE - CDX) + (GMCS 

- CDX).11

The A.M.A., Guides also provide that ROM impairment methodology is to be used as a 

stand-alone rating for upper extremity impairments when other grids direct its use or when no other 

DBI sections are applicable.12 If ROM is used as a stand-alone approach, the total of motion 

impairment for all units of function must be calculated. All values for the joint are measured and

added.13 Adjustments for functional history may be made if the evaluator determines that the 

resulting impairment does not adequately reflect functional loss and functional reports are 

determined to be reliable.14

6

Supra note 2.

7

20 C.F.R. § 10.404.

8 For decisions issued after May 1, 2009,the sixth edition of the A.M.A., Guidesis used. A.M.A., Guides, (6th ed. 

2009); Federal (FECA) Procedure Manual, Part 2 -- Claims, Schedule Awards and Permanent Disability Claims, 

Chapter 2.808.5(a) (March 2017); see also Part 3 -- Medical, Schedule Awards, Chapter 3.700, Exhibit 1 

(January 2010).

9 P.R., Docket No. 19-0022 (issued April 9, 2018); Isidoro Rivera, 12 ECAB 348 (1961).

10 A.M.A., Guides 383-492.

11 Id. at 411.

12 Id. at 461.

13 Id. at 473.

14 Id. at 474.
5

OWCP issued FECA Bulletin No. 17-06 to explain the use of the DBI methodology versus

the ROM methodology for rating upper extremity impairments.15 Regarding the application of 

ROM or DBI impairment methodologies in rating permanent impairment of the upper extremities, 

FECA Bulletin No. 17-06 provides in pertinent part:

“Upon initial review of a referral for upper extremity impairment evaluation, the 

DMA should identify: (1) the methodology used by the rating physician (i.e., DBI 

or ROM); and (2) whether the applicable tables in Chapter 15 of the [A.M.A.,] 

Guidesidentify a diagnosis that can alternatively be rated by ROM. If the [A.M.A.,] 

Guides allow for the use of both the DBI and ROM methods to calculate an 

impairment rating for the diagnosis in question, the method producing the higher 

rating should be used.” (Emphasis in the original.)16

The Bulletin further advises:

“If the rating physician provided an assessment using the ROM method and the 

[A.M.A.,] Guides allow for use of ROM for the diagnosis in question, the DMA 

should independently calculate impairment using both the ROM and DBI methods 

and identify the higher rating for the [claims examiner] CE.”

17

OWCP’s procedures provide, “In general, loss of less than one digit should be computed 

in terms of impairment to the digit itself (thumb, finger, etc.), and loss of two or more digits should 

be computed in terms of impairment to the whole hand or foot. Where the residuals of an injury 

to a member of the body specified in the schedule extend into an adjoining area of a member also 

enumerated in the schedule, such as an injury of a finger into the hand, of a hand into the arm or 

of a foot into a leg, the schedule award should be made based on the percentage loss of use of the 

larger member.”

18

 

OWCP’s procedures provide that, after obtaining all necessary medical evidence, the file 

should be routed to an OWCP medical adviser for an opinion concerning the nature and percentage 

of impairment in accordance with the A.M.A., Guides, with the medical adviser providing 

rationale for the percentage of impairment specified.19

15 FECA Bulletin No. 17-06 (issued May 8, 2017).

16 A.M.A., Guides 477.

17 FECA Bulletin No. 17-06 (issued May 8, 2017); V.L.,Docket No. 18-0760 (issued November 13, 2018);

A.G., Docket No. 18-0329 (issued July 26, 2018).

18 Supra note 8 at Chapter 2.808.5e (March2017); see C.W.,Docket No. 17-0791 (issued December 14, 2018);

Asline Johnson, 42 ECAB 619 (1991); Manuel Gonzales, 34 ECAB 1022 (1983).

19 Supra note 8 at Chapter 2.808.6(f) (March 2017); see D.J., Docket No. 19-0352 (issued July 24, 2020).
6

ANALYSIS

The Board finds that appellant has not met his burden of proof to establish greater than five 

percent permanent impairment of the left thumb, for which he previously received a schedule 

award.

In an impairment evaluation dated October 6, 2020, Dr. Allen reviewed appellant’s 

complaints of pain and numbness in the thumb with reduced flexion. On examination he found 

some tenderness and reduced sensation of the thumb with full muscle strength. Dr. Allen measured 

ROM of the left wrist, which yielded normal findings, and ROM of the left thumb, which showed 

a mild loss of flexion of the IP joint symmetrical with the loss on the right side. Using the DBI 

impairment method, he identified the CDX as 1 for distal phalanx fracture, which yielded a default 

impairment of four percent under Table 15-2 on page 393 of the A.M.A., Guides. Dr. Allen found 

a GMFH of 2, and GMPE of 1, and that a GMCS was inapplicable. He applied the net adjustment 

formula to find a total impairment of the left thumb of five percent.20 Dr. Allen converted the five 

percent permanent impairment of the thumb to two percent permanent impairment of the left upper 

extremity. He did not, however, explain why appellant’s thumb impairment extended into the 

upper extremity. The Board has held that a medical report is of limited probative value on a given 

medical matter if it contains a conclusion regarding that matter which is unsupported by medical 

rationale.

21

 

On May 3, 2021 Dr. Hammel concurred with Dr. Allen’s finding of five percent permanent 

impairment of the left thumb. In an April 6, 2022 report, he reiterated that appellant had no more 

than five percent permanent impairment of the left thumb. Dr. Hammel noted that the A.M.A., 

Guides provided that a digit impairment should remain a digit impairment absent involvement of 

multiple digits or if it required prior to conversion to a whole person impairment. 22 The Board 

finds that his report constitutes the weight of the evidence and establishes that appellant has no 

more than five percent permanent impairment of the left thumb. 

As the medical evidence of record does not contain a rationalized impairment rating 

supporting greater than the five percent permanent impairment of the left thumb previously 

awarded, the Board finds that appellant has not met his burden of proof. 

Appellant may request a schedule award or increased schedule award at any time based on 

evidence of a new exposure or medical evidence showing progression of an employment-related 

condition resulting in permanent impairment or increased permanent impairment.

20 Utilizing the net adjustment formula discussed above, (GMFH-CDX) + (GMPE-CDX), or (2-1) + (1-1) = 1, 

yielded a net adjustment of 1.

21 See L.J., Docket No. 22-0584 (issued August 15, 2022); D.H., Docket No. 17-0530 (issued July 2, 2018).

22 A.M.A., Guides 390.
7

CONCLUSION

The Board finds that appellant has not met his burden of proof to establish greater than five 

percent permanent impairment of the left thumb, for which he previously received a schedule 

award.

ORDER

IT IS HEREBY ORDERED THAT the October 25, 2022 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: July 17, 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