United States Department of Labor

Employees’ Compensation Appeals Board

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L.A., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE,

Vinita, OK, Employer

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Docket No. 22-0487

Issued: June 14, 2022

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

VALERIE D. EVANS-HARRELL, Alternate Judge

JAMES D. MCGINLEY, Alternate Judge

JURISDICTION

On February 17, 2022 appellantfiled a timely appealfrom a January 5, 2022merit 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 her burden of proof to establish a bilateral 

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

FACTUAL HISTORY

On December 1, 2021 appellant, then a 48-year-old window clerk, filed an occupational 

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

factors of her federal employment, including repetitive movements while sorting letters and flats, 

and scanning packages. She explained that she initially experienced bilateral hand numbness while 

sleeping, but that her symptoms progressed and started to occur during the day. Appellant noted

1

5 U.S.C. § 8101 et seq.
2

that she first became aware of her condition on August 8, 2021 and realized its relation to her 

federal employment on November 16, 2021. She did not stop work.

In a December 3, 2021 development letter, OWCP informed appellant of the deficiencies 

of her claim. It advised her of the type of factual and medical evidence necessary to establish her

claim and provided a questionnaire for her completion. 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.

In a medical report dated November 8, 2021, Shiela Williams, a certified nurse practitioner, 

related that appellant had been experiencing numbnessin her hands while sleeping for four months 

and subsequently developed fluctuating bilateral hand pain following an incident involving an 

“unknown” mechanism of injury that occurred more than a week prior.

On November 23, 2021 appellant was seen by Dr. Gregory S. Connor, a Board-certified 

neurologist, who examined her for bilateral hand numbness. On that date, Dr. Connor performed

an electromyography (EMG) and nerve conduction velocity (NCV) study of both arms. He 

diagnosed radiculopathy, bilateral median neuropathies at the wrist, and right ulnar neuropathy at 

the elbow.

By decision dated January 5, 2022, OWCP denied appellant’s occupational disease claim, 

finding that the medical evidence of record was insufficient to establish a bilateral hand/wrist

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

LEGAL PRECEDENT

An employee seeking benefits under FECA2 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,3that 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.4 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.5

To establish that an injury was sustained in the performance of duty in an occupational 

disease claim, a claimant must submit: (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 

2

Supra note 1.

3 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). 

4 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).

5 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).
3

compensation is claimed; and (3) medical evidence establishing that the diagnosed condition is 

causally related to the identified employment factors by the claimant.

6

 

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

condition and an employment factor is rationalized medical opinion evidence.7 The opinion of the 

physician must be based on a complete factual and medical background of the employee, 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 factors. 8

ANALYSIS

The Board finds that appellant has not met her burden of proof to establish a bilateral hand

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

In support of her claim, appellant submitted Dr. Connor’s November 23, 2021 medical 

report, wherein he diagnosed radiculopathy, bilateral median neuropathies at the wrist, and right 

ulnar neuropathy at the elbow following an EMG/NCV study. However, Dr. Connor did not 

provide an opinion on causal relationship. The Board has held that medical evidence that does not 

offer an opinion regarding the cause of the employee’s condition is of no probative value on the 

issue of causal relationship.9 As such, Dr. Connor’s November 23, 2021 medical report is 

insufficient to establish the claim. 

The remaining medical evidence consists of a November 8, 2021 treatment note from

Ms. Williams, a nurse practitioner, who examined appellant for symptoms of pain and numbness 

of the hands. The Board has held that medical reports signed solely by a nurse practitioner are of 

no probative value because such providers are not considered physicians as defined under FECA. 10 

This report, therefore, is also insufficient to establish appellant’s claim.

The medical evidence of record is insufficient to establish a bilateral hand condition that is 

causally related to the accepted factors of appellant’s federal employment. As a result, the Board 

finds that she has not met her burden of proof.

6 T.W., Docket No. 20-0767 (issued January 13, 2021); L.D., Docket No. 19-1301 (issued January 29, 2020); S.C., 

Docket No. 18-1242 (issued March 13, 2019).

7

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).

8 T.L., Docket No. 18-0778 (issued January 22, 2020); Y.S., Docket No. 18-0366 (issued January 22, 2020); 

Victor J. Woodhams, 41 ECAB 345, 352 (1989).

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

10 Section 8101(2) of FECA provides that a physician includes surgeons, podiatrists, dentists, clinical psychologists, 

optometrists, chiropractors, and osteopathic practitioners within the scope of their practice as defined by State law. 5 

U.S.C. § 8101(2); 20 C.F.R. § 10.5(t). SeeFederal (FECA) Procedure Manual, Part 2 --Claims,Causal Relationship,

Chapter 2.805.3a(1) (January 2013); DavidP. Sawchuk, 57 ECAB 316, 320 n.11 (2006) (lay individuals such as 

physician assistants, nurses, and physical therapists are not competent to render a medical opinion under FECA); see 

also B.V., Docket No. 21-0742 (issued December 14, 2021) (nurse practitioners are not considered physicians as 

defined under FECA); M.C.,Docket No. 19-1074 (issued June12, 2020).
4

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 a bilateral 

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

ORDER

IT IS HEREBY ORDERED THAT the January 5, 2022 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: June 14, 2022

Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board