United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

J.L., Appellant

and

DEPARTMENT OF HEALTH & HUMAN 

SERVICES, NATIONAL DISASTER MEDICAL 

SYSTEM, Seattle, WA, Employer

__________________________________________

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Docket No. 23-0830

Issued: October 6, 2023

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

PATRICIA H. FITZGERALD, Deputy Chief Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On May 24, 2023 appellant filed a timely appeal from a December 2, 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 her burden of proof to establish a medical condition 

causally related to the accepted factors of her federal employment.

FACTUAL HISTORY

On April 6, 2022 appellant, then a 56-year-old logistics manager, filed an occupational 

disease claim (Form CA-2) alleging that, while working as an autopsy technician, she developed 

wrist and arm pain, tingling, and numbness due to factors of her federal employment as an

intermittent employee. She explained that her symptoms developed due to the evisceration of 

1

5 U.S.C. § 8101 et seq.
2

organs, collecting biological sample and cleaning. Appellant noted that she first became aware of 

her conditions and realized their relationship to her federal employment on March 8, 2022. 

On March 16, 2022 appellant sought treatment with Dr. Andrew M. Dym, a Boardcertified internist. Dr. Dym related that she experienced bilateral hand numbness after “heavy 

work” performing repeated autopsies. He indicated carpal tunnel syndrome was likely and noted 

the need for a nerve conduction velocity (NCV) study. 

In a development letter dated April 11, 2022, OWCP indicated that the evidence provided 

was insufficient to establish that appellant actually experienced the employment factors alleged to 

have caused injury. It requested that she provide a narrative report from a physician containing a 

detailed description of findings and a diagnosis, as well as a medical explanation from a physician 

as to how the employment factors caused or aggravated a medical condition. OWCP afforded 

appellant 30 days to respond. In a separate development letter of even date, it requested that the 

employing establishment provide additional information, including comments from a 

knowledgeable supervisor. 

In a completed questionnaire received on April 21, 2022, appellant indicated that she was 

deployed to Maryland to assist in autopsies under the National Disaster Medical System. Her 

duties included repetitive movements,such as drawing fluids, eviscerating organs, moving human 

remains, and cutting through the body and skull. Appellant performed 80 cases in a span of 12 

days. She noted previously having de Quervain’s tendinitis in 1996 as part of a previous 

employment as an autopsy technician. Appellant further noted thatshe was currently employed 

as a community corrections officer outside of federal employment.

In a letter received on May 4, 2022, the employing establishment related that appellant was 

deployed on a 14-day mission to Baltimore, MD assisting the Office of Medical Examiner. It

noted her duties of moving human remains, cutting, drawing fluids, and restocking supplies. 

By decision dated May 24, 2022, OWCP denied appellant’s occupational disease claim, 

finding that the evidence of record was insufficient to establish a diagnosed medical condition

causally related to the accepted employment factors. It concluded, therefore, that the requirements 

had not been met to establish an injury as defined by FECA. 

On June 13, 2022 appellant requested an oral hearing before a representative of OWCP’s 

Branch of Hearings and Review regarding the May 24, 2022 decision. A hearing was held on 

October 20, 2022. 

By decision dated December 2, 2022, OWCP’s hearing representative affirmed the 

May 24, 2022 decision. 

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, that an injury was sustained in the performance of duty as alleged, and that 

2

Id.
3

any disability or medical condition for which compensation is claimed is causally related to the 

employment injury.3 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.4

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 

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

causally related to the identified employment factors by the claimant.5

Causal relationship is a medical question that requires rationalized medical opinion 

evidence to resolve the issue.6 The opinion of the physician must be based on a complete factual 

and medical background, 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 

the specific employment factors.7 Neither the mere fact that a disease or condition manifests itself 

during a period of employment, nor the belief that the disease or condition was caused or 

aggravated by employment factors or incidents is sufficient to establish causal relationship. 8

ANALYSIS

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

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

Appellant was treated by Dr. Dym on March 16, 2022. Dr. Dym indicated that appellant 

likely had carpal tunnel syndrome and noted the need for an NCV test. However, he 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 an employee’s condition is of no probative value on the 

issue of causal relationship.9 These reports, therefore, are insufficient to establish appellant’s 

claim.

Appellant also submitted narrative statements in support of her claim. As noted above, 

causal relationship is a medical question that requires rationalized medical opinion evidence to 

3

J.M., Docket No. 17-0284 (issued February 7, 2018);R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40 

ECAB 312 (1988).

4 B.H., Docket No. 20-0777 (issued October 21, 2020); 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

S.H., Docket No. 22-0391 (issued June 29, 2022); 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).

6 D.S., Docket No. 21-1388 (issued May 12, 2022); I.J., Docket No. 19-1343 (issued February 26, 2020);T.H., 59 

ECAB 388 (2008); Robert G. Morris, 48 ECAB 238 (1996).

7 D.S. id.; D.J., Docket No. 19-1301 (issued January 29, 2020).

8 T.M., Docket No. 22-0220 (issued July 29, 2022); S.S., Docket No. 18-1488 (issued March 11, 2019); see also

J.L., Docket No. 18-1804 (issued April 12, 2019).

9

See L.B., Docket No. 18-0533 (issued August 27, 2018); D.K., Docket No. 17-1549 (issued July 6, 2018).
4

resolve the issue.10 A lay opinion regarding causal relationship does not constitute probative 

medical evidence.11 Appellant’s statements are therefore also insufficient to establish the claim.

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

diagnosed medical condition and appellant’s accepted employment factors, the Board finds that 

appellant 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 a medical 

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

ORDER

IT IS HEREBY ORDERED THAT the December 2, 2022 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: October 6, 2023

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board

10 Supra note 6.

11 See E.H., Docket No. 19-0365 (issued March 17, 2021).