J.L. and U.S. Postal Service, Dalton Post Office, Dalton, GA (Board decision, October 31, 2023)

ECAB final decision. The Board affirmed OWCP's March 1, 2023 denial of J.L.'s occupational disease claim. It found that his doctor's reports did not adequately explain how his postal duties caused or aggravated his left thumb condition. A party may petition the Board for reconsideration within 30 days of issuance unless this order specifies another period, under 20 C.F.R. § 501.7(a). FECA compensation decisions are generally not subject to court review under 5 U.S.C. § 8128(b).

Plain-English summary

J.L., a postal carrier technician, attributed left thumb pain to casing mail and gripping a vehicle steering wheel at work. His doctor diagnosed thumb arthritis and linked his pain to a steering wheel incident and repetitive duties. The Board found that her explanation did not identify how the specific work movements caused or aggravated the condition. A form on which she checked a box saying the condition was work-related also lacked medical reasoning. The Board affirmed OWCP's denial because the medical evidence did not establish the required connection to work.

Decision snapshot

• Authority: FECA occupational disease causation standard; 20 C.F.R. § 501.7(a).
• Outcome: Denial of left thumb occupational disease claim affirmed.
• Key point: A checked box and a general link to repetitive duties do not substitute for medical reasoning about causation.

Full text (ECAB public release)

United States Department of Labor
Employees’ Compensation Appeals Board

________
)
J.L., Appellant
)
)
and ) Docket No. 23-0702
)
Issued: October 31, 2023
U.S. POSTAL SERVICE, DALTON POST )
OFFICE, Dalton, GA, Employer
)
__________ )

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 April 19, 2023 appellant filed a timely appeal from a March 1, 2023 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 left thumb condition causally related to the accepted factors of his federal employment.

FACTUAL HISTORY

On January 23, 2023 appellant, then a 55-year-old carrier technician, filed an occupational disease claim (Form CA-2) alleging that in August 2022 he developed a left thumb condition due to factors of his federal employment, which included casing mail and gripping the steering wheel

1
5 U.S.C. § 8101 et seq. throughout the course of his workday. He noted that he first became aware of his condition and realized its relation to his federal employment on August 15, 2022. Appellant did not stop work.

In a November 28, 2022 report, Dr. Sierra G. Phillips, a Board-certified orthopedic surgeon, reported that appellant presented for evaluation of left thumb pain localized at the base which had been ongoing for three to four months. She noted that appellant worked as a mailman and believed that his pain was related to jamming his thumb in his steering wheel, as well as carrying heavy objects and opening mailboxes in his employment duties. Appellant reported that his pain improved when he was not working and would worsen after overuse from his employment duties at the end of the workday. Dr. Phillips noted a prior right thumb carpometacarpal (CMC) joint arthroplasty performed by a different surgeon one year prior. She reviewed April 19, 2022 diagnostic studies of the hands, which demonstrated right-hand posttrapeziectomy changes and scaphotrapeziotrapezoidal degenerative changes. Dr. Phillips noted that the left hand revealed moderate thumb CMC degenerative changes. She diagnosed left thumb CMC arthritis. Dr. Phillips noted the natural history of arthritis and the natural progressive nature with intermittent flareups. She opined that appellant’s recent bout of pain was related to the steering wheel injury from work, which had been exacerbated by the repetitive activities required by his job. Dr. Phillips suggested conservative treatment and provided an intra-articular steroid injection at the site of injury.

In a January 9, 2023 report, Dr. Phillips noted his evaluation of appellant and noted improvement following the last intra-articular injection administered into the left thumb. She related that appellant wore a brace with difficulty when there was an increasing workload. Dr. Phillips recommended continued conservative treatment. In an attending physician’s report (Form CA-20) of even date, Dr. Phillips diagnosed left thumb CMC arthritis. She checked a box marked “Yes” indicating that the diagnosed condition was caused or aggravated by an employment activity.

In a January 22, 2023 narrative statement, appellant described the employment duties he attributed to the cause of his left thumb injury. He reported that he began to experience left thumb pain on or around August 15, 2022, when he was driving his postal truck and caught his thumb in the steering wheel as he was making a turn onto another street. The pain continued to worsen over the next few months, causing him to seek treatment with an orthopedic physician. Appellant further described his regular employment duties throughout his workday, which exacerbated his left thumb condition by pushing down the thumb joint, resulting in pain. These tasks included holding stacks of flats in his left hand as he cased mail, thumbing through mail with his left hand for deliveries, casing mail for one to two hours each day, gripping the steering wheel and steering throughout the day, and driving the postal truck to deliver mail for six to eight hours per day, which caused increasing pain in his left thumb. He explained that any other use of his left hand for gripping caused pain in his thumb joint. Appellant reported no previous left thumb condition prior to this injury.

In a January 27, 2023 development letter, OWCP informed appellant of the deficiencies of his claim. It advised him as to the type of factual and medical evidence required and provided a questionnaire for his completion. In a separate development letter of even date, OWCP requested that the employing establishment provide additional information pertaining to appellant’s occupational disease claim. It afforded both parties 30 days to respond.

2
Following OWCP’s development letter, appellant resubmitted Dr. Phillips’ January 9, 2023 medical report.

By decision dated March 1, 2023, OWCP denied appellant’s occupational disease claim, finding that the medical evidence of record was insufficient to establish causal relationship between his diagnosed left thumb condition and the accepted factors of his federal employment.

LEGAL PRECEDENT

An employee seeking benefits under FECA 2 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, 3 that 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, an employee 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 employment factors identified by the employee. 6

Causal relationship is a medical question that requires rationalized medical opinion evidence to resolve the issue. 7 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.8 Additionally, the physician’s opinion must be expressed in terms of a reasonable degree of medical certainty, and must be supported by medical

2
Id.
3
E.K., Docket No. 22-1130 (issued December 30, 2022); F.H., Docket No. 18-0869 (issued January 29, 2020);
J.P., Docket No. 19-0129 (issued April 26, 2019); Joe D. Cameron, 41 ECAB 153 (1989). 4 S.H., Docket No. 22-0391 (issued June 29, 2022); 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 E.H., Docket No. 22-0401 (issued June 29, 2022); P.A., Docket No. 18-0559 (issued January 29, 2020);
K.M., Docket No. 15-1660 (issued September 16, 2016); Delores C. Ellyett, 41 ECAB 992 (1990). 6 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). 7 S.M., Docket No. 22-0075 (issued May 6, 2022); S.S., Docket No. 19-0688 (issued January 24, 2020);
A.M., Docket No. 18-1748 (issued April 24, 2019); Robert G. Morris, 48 ECAB 238 (1996). 8 M.V., Docket No. 18-0884 (issued December 28, 2018).

3 rationale explaining the nature of the relationship between the diagnosed condition and appellant’s specific employment factor(s). 9

ANALYSIS

The Board finds that appellant has not met his burden of proof to establish a left thumb condition causally related to the accepted factors of his federal employment.10

In support of his claim, appellant submitted reports dated November 28, 2022 and January 9, 2023, wherein Dr. Phillips noted that appellant complained of continued left thumb pain at the base following a work-related incident when he caught his thumb in the steering wheel of his postal vehicle. Dr. Phillips described appellant’s employment duties, which she attributed to his injury. She opined that appellant’s recent bout of pain was related to the work-related steering wheel injury, which had been exacerbated by his repetitive employment duties. However, Dr. Phillips’ statement that appellant’s employment duties caused his claimed left thumb condition is vague and generalized in the absence of medical rationale explaining how the specific movements caused or contributed to the diagnosed condition.11 The Board has held that without explaining how appellant’s employment duties caused or aggravated his condition, an opinion on causal relationship is of limited probative value. 12 Thus, these reports are insufficient to meet appellant’s burden of proof.

The January 9, 2023 Form CA-20 is also insufficient to establish appellant’s claim. In a Form CA-20 dated January 9, 2023, Dr. Phillips diagnosed left thumb CMC arthritis and checked a box marked “Yes” indicating that the diagnosed condition was caused or aggravated by the reported employment activity. However, she provided no rationale for her opinion on causal relationship. The Board has held that when a physician’s opinion on causal relationship consists only of checking “Yes” to a form question, without more by the way of medical rationale, that opinion is of limited probative value and is insufficient to establish causal relationship. 13 As such, this report is insufficient to establish the claim.

As the medical evidence of record is insufficient to establish causal relationship between appellant’s diagnosed left thumb condition and the accepted factors of his federal employment, the Board finds that he has not met his burden of proof. 14

9
J.D., Docket No. 22-0935 (issued December 16, 2022); 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). 10 C.J., Docket No. 22-1015 (issued March 31, 2023); J.D., Docket No. 21-0470 (issued December 2, 2022).
11
R.T., Docket No. 18-0581 (issued October 3, 2018).
12
See A.P., Docket No. 19-0224 (issued July 11, 2019).
13
S.T., Docket No. 22-1025 (issued January 3, 2023).
14
I.D., Docket No. 22-0848 (issued September 2, 2022); T.G., Docket No. 14-751 (issued October 20, 2014).

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 his burden of proof to establish a left thumb condition causally related to the accepted factors of his federal employment.

ORDER

IT IS HEREBY ORDERED THAT the March 1, 2023 decision of the Office of Workers’ Compensation Programs is affirmed.

Issued: October 31, 2023
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

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