Howard v. D.C. Employment Services - Workers' Compensation Appeal

Notice: This opinion is subject to formal revision before publication in th e Atlantic and Maryland Re porters. Use r s are requeste d to notify the Cle rk of the Court of any formal errors so that c orrections may be made before the bound volume s go to press. DISTRICT OF COLUM BIA COURT OF APP EALS No. 24 - AA - 0279 H OWARD U NIVE RSITY H OSPITAL, et al., P ETITIONERS, V. D.C. D EPARTMENT OF E MPLOYMENT S ERVICES, R ESP ONDENT, and C AROLINE M C C AL L, I NTERVENOR. On Petition for Re view of an Order of the District of Colum bia Department of Em ployment Service s Compensation Re view Board (2023 - CRB - 000068) (Hon. Donna J. Hende rson, Administrat ive Law Judge) (Submitted Nove mber 4, 2025 Decided February 26, 2026) Matthew E. F ioravante and Sheryl A. Tirocchi and were on the brief for petitioners. Brian L. Schwalb, Attorney Genera l for the District of Columbia, C aroline S. Van Zile, Solicitor General, As hwin P. Phatak, Princ ipal Deputy Solici tor General, and Graham E. Phillips, Deputy Solic itor General, filed a Statement in Lieu of Brief for respondent. Krista DeSmyter and Kevin H. Stillman w ere on the brief for inte rvenor. Before E ASTERLY, D EAHL, and S HANKER, Associate J udge s.

2 D EAHL, Associate Judge: Caroline McCa ll worked at Howard Universit y Hospital for ove r twenty years until De cember 2020, when she re signed after experiencing years of hand pain and twice undergoing surgery on her right han d because of bila teral carpal tunne l syndrome. After her resignation, McCall applied for temporary total disability benefits under the D.C. Workers ’ Compensation Act. An A dministrative L aw Ju dge concluded that McCall ’s carpal tunnel syndrome was an “occup ational d isease” th at caused h er to re sign and granted he r claim fo r temporary tota l disability benefits. The ALJ’s order was upheld by th e Compensation Re view Board (CR B). Howard now petition s this court fo r review of the CRB’ s decis ion. It argu es that (1) the CRB ap plied the wrong legal standard for evaluat ing whether McCa ll could perform the duties of her “ usual job ”; (2) the CRB’s findings were not supported by substan tial evidence; and (3) the CRB should have remanded to the ALJ to evaluate whether Mc Call voluntarily retir e d for reasons unrela ted to her disability. We disagree and affirm. I. Factual and Pr ocedural Background From April 1998 to December 2020, Caroli ne McCall worked as a C linical S ystems C oordinator in the Perioperative Service s D epartment at Howard University Hospital. Her primary job was to manage the D epart ment’s inventory

3 control and informa tion technology syste ms, though her specific duties cha nged over time. Her original duties involved or der ing supplies for seven sub - depart ments within Periopera tive Service s, tracking and stocking those supplies, and working regularly with vendors and hospita l staff to m anage inventory. By 2008, she was also tasked with m anaging t he department’s software system, training staff to us e this system, creating databases for sub - departmen ts, and tracking “[a]ny [body ] tissue that came into the hospital.” McCall b egan experiencing hand and arm pain on her left side in February 2013. B y 2016 the pain had sprea d to both sides, and a doctor diagnosed he r with bilateral ca rpal tunnel syndrome caused by “inte nse hand activity at the workplace.” A different doct or confirmed tha t diagnosis and rec om mended surgery, which McCall received on he r right side in Janua ry 2017. The surgery put McCall out of work for four mont hs, and t he hospital voluntarily paid h er temporary tota l disability benefits during this period. Her doctor medically cleare d her to return to work but only if she was provided with certain accom m odations, including an ergonomic d esk setup, limited lifting, and frequent breaks. Although McC all received help li fting boxes when she return ed, her keyboarding duties incre ased, and sh e claims the hospital did not give her a new desk because of financial c oncerns.

4 McCall’s pain still had not abated by 201 8, so she sought treatme nt from Dr. Garth Smith. Like t he previous doctor s, D r. Smith characte rized her car pal tunn el as “ [w] ork related,” and he recommended a sec ond surgery on her right side. This surgery, which took pla ce in January 2019, involved “fat grafting” and “revis ion decompression” to pr otect the median nerve of her right wrist. Howard again paid McCall disability benefits while she was out of work after that surge ry. McCall’ s occupational therapist n oted several months later t hat she would “be nefit from returning to w ork on restricted duty ” with limits on lifting as well as an “L” - shape d desk with an ergonomic chair and two keyboards and tw o monitors to reduce stres s on her upper bod y and extremities. Dr. Smith ’s recommendation w as consistent with this list of accommodation s and st ated that McCall could not “fully perform a ll of the essential func tions” of her job without them. When McCall return ed to work, Howard did not pr ovide all of the prescribed accommodations. Although s he was given a n ergonomic chair and a gel pa d for her mouse, s h e was not given an “L”- shaped desk or a second compute r with a sep arate keyboard. 1 In addition, her keyboard was plac ed in a tray with a metal rod that ran 1 Howard did provide McCall with a second monitor, but it conn ected to th e same computer as the origina l monitor, wh ich did not account for the fact that her accommodations re commended two s eparate computers with separa te keyboards to avoid head - turning. The hospital also provided her with a laptop, but wi th out an ergonomic keyboa rd or mouse.

5 across the base of her hands and irritated the fa t graft in her right wrist. She as ked for her desk setup to be corrected, but it never was, thoug h Howard di d replace h er keyboard tray w ith a gel pad at some point. McCall al so assumed new job duties when she re turned to work. On top of her inventory and tis sue “graft tracki ng” responsibili ties, McCall had to “implement a new surgica l system” and train the operating room and endoscopy sta ff on how to use the new syste m. In addition, she had to mana ge the “blood bank m achine” a fter one of the operating room managers left. When Dr. Smit h evalu ated M cCall in September 2020, he rec ommended left hand surgery a nd noted that she was still experiencing wrist and joint pain that had “occur[red] in the context of an injury at work.” In December 2020, McCall resigned from the hospital. S he stated in her two - week no tice letter tha t she had “decided to make a life changing decision” and was “retir ing ” with “reservation,” noting that she had s tayed at the hospital “as long as [she] could. ” M cCall testified that she left b ecause her supervisors “kept adding more responsibilit y ” and by the end she was “ment al ly [and] physically exha usted” and “didn’t feel [she ] could take it anymore.” She added later that she did not want to resign, e specially be cause she had re cently rece ived a raise, but that by December her “ hands wer e hurting so bad [she] coul dn’t go back” to her job.

6 Two week s after M cCall r esign ed, the hospital arrange d for her to attend an independent me dical evaluation with Dr. Noah Raizma n. Dr. Raizman confirmed that McCall had “resolved carpal tunnel s yndrome ” on her right side and li ngering hand pain on both sides. But he found “no clear occupational ba sis” for these symptoms. In addition, Dr. R a izman s tat ed he w as “s kep tical” about the original diagnos is that her conditions st emmed from her work, and he noted as an aside that McCall told him she had quit “becaus e a cowo rker also left” and b ecause sh e felt “overwhelme d” and “bombarded with wo rk.” He concluded that her injuries ha d reached “ maximum medical improvement” and that she “would be capable of ful l duty work in her prior p ositio n as a peri - operative nursing c oordinator. ” McCall contested this conclusion, cla i ming that Dr. Raizma n had only reviewed her writte n job description and did not know what her job “actually re quired.” Several months late r, McCall reac hed out to the hos pital and requested a pa rt - time or remote role in her old depa rtment. Af ter hear ing nothing from the hospital, she sought remote work e lsewhere wit h no success. L ater, when asked if she would return to her old de partment and work on an “as - needed” ba sis, McCall said she would if her accommod ations wer e met or if she c ould work from hom e. She a dded that she could perform most of he r previous role from home and that she could focus on her computer dut ies without having to lift boxes or ma nage inventory.

7 McCall then a pplied for temporary total disabil ity bene fits from Decem ber 2020 to the prese nt. A fter a formal hearing, th e ALJ concluded that McCall was “ temporarily totally disabled ” and awarded her benefits dating back to December 2020. The ALJ found McCall ’s testimony about her pain and symptoms, her increased job dutie s, and the hospital ’s failure to ac commodate her to be “ credible based upon her be havior and demea nor.” The ALJ also found that M cCall ’s carpal tunnel syndrome w as “ medically causally related to her job ” bas ed on her “treatin g physician’s c urrent attributio n of her symptoms to he r occupational duties.” Applying the test set forth in Logan v. D.C. Dep’t o f Emp. Servs., 805 A.2d 237 (D.C. 2002), the ALJ conc luded that McCall was temporarily totally disabled, noting that she had not “voluntarily limite d her income ” because her position had changed and Howard “fai led to make t he accommodat ions necessa ry for her to return t o work.” T he CRB af firmed th e ALJ’s order, holding that the ALJ properly applie d the Logan test and based her de cision on sub stantial ev idence. Howard now challenges tha t ruling. II. Analysis Th e main dispute bet ween th e parties is whether McCall’s carpal tunne l sy ndrome amount ed to a “total disability ” under the framework se t forth in Logan,

8 805 A.2d at 242 - 43. 2 The CRB affirmed the ALJ’s order, and we rev iew the CRB’s decision to determine if i t “flows rationa lly from the fa cts ” and if “ th ose facts are supported by substan tial evidence on the re cord.” Howard Univ. Hosp. v. D.C. Dep’t of Emp. Servs., 329 A.3d 292, 295 (D.C. 2025); see id. (noting that our standard of review “mirrors tha t which the [CRB] is bound to apply” to t he ALJ’s decision). Under Logan, an emplo yee has the burden of maki ng out a pr ima facie case of total disability, which they can do by showing th at they cannot return to their “usual job.” Logan, 805 A.2d at 242 - 43 (citing Crum v. Gen. Adjustmen t Bureau, 738 F.2d 474, 4 79 (D.C. Cir. 1984)). If an emplo yee makes out that case, t he burden shifts to the employer to presen t evidence that the claim ant could perform a differe nt position based on th eir age, vocational background, and physic al and men tal a bility. See id. at 243. Th e emp loyee can then refute that by challenging the employe r’s evidence or by de monstrating their own diligence, bu t lack of su ccess, in findin g another job. See i d. Not ably, if the em pl oyee “voluntari ly limits [her] in come” by retiring for re asons unrela ted to her disability, she is not eligible for benefit s. Baliles v. D.C. Dep’ t of Emp. Servs., 728 A.2d 661, 664 - 65 (D. C. 1999). 2 Howard Hospita l does not cha llenge the holding that McCa ll’s carpal tunnel syndrome wa s medically caused by he r job, and McCall agrees that he r disability is only “temporary” in na ture.

9 Howard argues that the C RB (1) applied the incorrect le gal stand ard when it held McCall cou ld not return to her “usual job” by ref erence to her job duties a s they existed in Decembe r 2020, as opposed to 2013; (2) failed to base its decision on substantial evidenc e; and (3) should hav e remanded because the ALJ faile d to consider its de fense that McCall retired for reasons unrela ted to her disabili ty. We consider these arguments in turn. A. The CRB applied the correct legal standard in evaluat ing McCall’s cl aim for temporary total disability benefits Howard argues tha t the releva nt question for determ ining whether McCall could perform her “usual job” under the first step of Logan is “ whether th e claiman t is currently a ble to perform the job tha t they held at the time of their injury. ” Because McCall’s injury first arose in early 2013, the argument goes that the ALJ and the CRB should ha ve ev aluated Logan step one by reference to her job duties as they existed in 2013, rathe r than when she resi gned in Decembe r 2020. Howard’s cla im hinges on interpre ting the phrase “usual job” from Logan to mean “pre - injury” job. It is tru e that we and th e CRB often analyze total disability claims under Logan by evaluating whether a claim ant employee c an perform th eir “pre - injury” job. Se e, e.g., M iranda v. D.C. Dep’t of Emp. Servs., 257 A.3d 467, 470 (D.C. 2021) (using the phrase “pre - injury job” w hen describing Logan step one).

10 What th e hospital misses, however, is that M cCall’s situation is different from the classic workers’ compensation case, wh ere a single work - related acciden t cause s a discrete injury. See id. at 469 (invol ving a single kne e injury that required mult iple surgeries). In those case s, there is no difference bet ween the claimant’s “usual” and “pre - injury” job s because th e ir single acc ident/ injury mark s the moment when the y could no longer work. But where a claiman t has a chronic me dical conditio n, the latest m anifestat ion of which has allegedly rendered the m totally disable d, “pre - injury job ” could mean eith er (a) the jo b the clai mant hel d just before th eir initial symptoms; or (b) the job they held when their most r ecent symptoms gave rise to their present disability c laim. The Logan step one inquiry focuses on the latter — i.e., whether a claimant can perform the duties of their job at the time t hey began experiencing the symptoms that gave rise to their disability claim. See Rocha - Guzm á n v. D.C. Dep’t of Emp. Servs., 170 A.3d 170, 17 7- 79 (D.C. 2017) (describing the “ relevant time - frame” for a total disability claim as the period for which the c laimant requeste d benefits). Here, the CRB correctly eval uated whether McCall could return to he r “usual job” under Logan by reference to her job dutie s as they existed in December 2020, when she all egedly could no longer work because of her carpal tunnel symptoms, rather than in February 2013, when she first sought trea tment for her hand pain.

11 B. Substantial ev idence supports the CRB’s holding that M cCall was entitled to temporary total disability benefits We now turn to the evidenti ary basis for the CRB’s decision that McCall was entitled to temporary total disability benefits. In affirming the ALJ’s order, the CR B upheld the AL J’s finding that McCall could not perform her “ usual job” becau se Howard “added the duties of seve ral positions.” The CRB t hen ruled that substantial evidence support ed the ALJ’s finding that McCall “did not un reasonabl y refuse to continue in [her ] position” because (1) Mc Call’s tasks “ had changed ”; (2) Howard did not provide al l of her r equired accommodat ions; and (3) Howard ignored her request for a “lighter duty” positi o n. Like the C RB, we se e no reaso n to disturb the ALJ ’s findings. O n the first step of Logan, McCall testified that she assumed several new dutie s when she returned to work a fter her second carpal tunnel surge ry — for example, she had to implement a ne w surgical system and manage the “blood ban k machine” — and her doctor told Howard that she could not perform her job without certain accommodations. S ome of the se accommodations we re never provided to McCall, and she testif ied th at, by Decembe r 2020, her hands were “hurting so bad [she] couldn’t go bac k” to work. As for suitable job alternatives, even assuming Howard could re but McCall’s prima faci e case under the second step of Logan, McCall testified that she requested a par t - time or remote job a t Howard to no avail and could

12 not find a job elsew here. See Logan, 805 A.2d at 243. The A LJ’s o rder is thus supported by substa ntial evidence. Howard raises several counterpoint s. First, it argues that the ALJ erred by failing to conside r Dr. Raizm an’s opinion, in a med ical eval uation after McCall’s resignation, that she “would be capable of full duty work in her prior positi on as a peri - operative nursing coordinator. ” The CRB rejected that arg ument becau se Dr. Raizman’s opinion w as not “wholly ignored” by the ALJ and, in any event, “no explanation is re quired ” for re j ecting an independent medica l opinion. See Marriott Int’l v. D.C. Dep’t of Emp. Se r vs., 834 A.2d 882, 886 (D.C. 2003) (“Excep t in the case of treat ing physicia ns, the [ALJ] is not required to gi ve reasons for rej ecting medical evide nce of one party tha t conflicts with medical evide nce presente d by another party. ”). Howard is correct that, w hile the ALJ addr essed the portion of Dr. Raizman’s opinion regarding m edical causat ion, s he did not d irectly address his statement that McCall was “capa ble of full duty work in her prior position. ” Contra id. (d escribi ng the ALJ’s decision to c redit one doctor over a nother as “amply justifie d”). That is a somewhat troublin g oversight, but not a fatal one. As the CRB noted, the ALJ found Raizman’ s opinion was “questionable ” as to whethe r M cCall’s carpa l tunnel sympto ms were “oc cu pationally relate d” because he contradi cted her “treati ng

13 physician ’s current attri bution of her symptom s to her occupational duties. ” 3 And as for his opinio n that McC all was “capabl e of full duty work,” Raiz man noted only that he had “revi ewed her job desc ription, ” whic h did not include the a dditional job duties she assumed, and he did not reference the a ccommodations that her doctors deemed were nec essary for her to return to work. Th e ALJ found that McCall was released to “full - duty, full - time work with accommodations” and could not pe rform her usual job because Howard “faile d to meet the accomm odations [her] treating physician presc ribed.” By making these findi ngs, t he AL J necessarily d eclined to credit Raizman’s opinion, and the ALJ’s failure to explicitly say as much is not grounds for reversa l. See Miranda, 257 A.3d at 471 (noting that we will “uphold a decision of less t han ideal clarity if the agency ’ s path may reasonably be disc erned”). It is obvious enough from the ALJ’s orde r that she rejec t ed Raizman’s conc lusion on this point. Howard also argues that the ALJ “ignored significant mater ial evid ence in the record” by failing to construe McCall’s two - week noti ce letter and her testimony about why she le ft Howard as evidence of a voluntary resignat ion. See Darden v. 3 The ALJ never identified who McCall’s “treating physician” wa s at the time of her claim. One of the cited exhibits refer s to Dr. Smith, who reported in September 2020 t hat McCall was still experiencing joint pain t hat “o ccur [red] in the context of a n injury at work.” The record a lso shows that M cCall beg an treatmen t with Dr. Kevin O’Mall ey in Septembe r 2021.

14 D.C. Dep’t o f Emp. Servs., 911 A.2d 410, 416 (D.C. 2006) (“A n agency fails to base its decision on substantial ev idence. . . when it ignores ma terial evidenc e in the record.”). Howard cites portions of McCall’s testimony that suggest she left her job because, for example, her supe rvisors “kept adding more responsibili ty.” Bu t McCall also testified that this extr a work made her hand pa in worse, to the point where it was “so bad [she ] couldn’t go bac k” to work. In any event, n either McCall’s notice lett er nor her varying explanations for why she left were ignored by the ALJ, which acknowle dged the conflic ting evidence an d weighed it in a m anner that is outside of our pu rview to rea ssess on appeal. See Marriott, 834 A.2d at 885 (“If substantial e vidence exists to support the hearing e xaminer’s findings, the existe nce of substantia l evidence to the contrary does not permit [us] to subst itute [our] judgment for tha t of the exam iner. ”). Finally, Howard challenges the ALJ ’s finding that it “failed to comply” with McCall’s presc ribed accommodations, which fa ctored into the holding that McCall was temporarily totally disabled. It is certainly true th at Howar d provide d some of the accommoda tions Mc Call’s doctor prescr ibed in 2017, including an e rgonomic keyboard, a gel mouse pad, and an ad justable ch air. But when McC all returned to work in 2020, the hospital did not give her an “L ”- shaped desk or a second com puter with a separate ke yboard, which were both liste d as required accommod ation s. Ev en if one might find these requests trivial, the CRB was cor rect to note t hat “som e

15 accommodations c an matter more than others,” and the hospital d id not e xplain why it failed to provide them all. Substantial evidenc e thus supports the ALJ’s finding s that Howard failed t o provide all of the nec essary accomm odations for McCall t o perform her the n - existing job duties. C. The CRB did not err in dete rmining that McCal l was forced to re sign because of her injury and did no t voluntarily limit her income Howard’s final claim, which overlaps significantly with its general substantial evidence claim, is that the CRB should have remanded the case to the ALJ be cause she failed to consider its argument tha t McCall retired for reasons unrelate d to her carpal tunnel syndrome and w as thus ineligible for disa bility benefits under Baliles, 728 A.2d 661. In Baliles, we held that a cl aimant who retired from his job had “voluntarily limited his income ” an d could not collect disability benefits because he was “cleared by his treating physic ian to return to his normal job” and “not hing in the record ” suggest ed his r etirement was relat ed to an earlier work injury. Id. at 665. By cont rast, McCal l ’s treating physician cleared her to return to work only with certain accommodations, and th e AL J found that Howard “failed to mak e the accommodations ne cessary for her t o return to work. ” In addition, McCall testified that she wanted to return to Howard in a different role but w as ignored. See Howard, 329 A.3d at 296 (“To prove a claimant has voluntarily li mited [her] incom e, the

16 employer must demonstrate the availability of suit able jobs that the employee has foregone”). Given this evidenc e in the record, Baliles does not help Howard ’ s case. We are also not persuaded that the AL J failed to consider H oward’s voluntary retirement argument i n the first instance. Although the ALJ never specifically cited Baliles in her order, she “reject[ed] ” Howar d ’s argument that McCal l “simply could not stand the stress of her pre - injury position” and found that McCall “did not unreasonably resign ” from her position. These findings adequately address ed Howard’s argume n t, and the ALJ had a strong foundation for characteriz ing McCall’s depa rture as a resignation as opposed to a retirement. Cf. W ash. Metro. Area Transit A uth. v. D.C. Dep’t of Emp. Se rvs., 731 A. 2d 845, 846 (D.C. 1999) (affirming tha t a claiman t can coll ect disability benefits in addition to retiremen t benefits from t heir employer). It is true, as Howard stresses, that M cCall initially described herself a s “retiring,” but her word choice does not have talismanic leg al eff ect. Ho wever sh e described the ba sis for her departure, the ke y question rema ins whether M cCall left because of her work - related injury or for unrela ted reasons. W e ack nowledg e that there is s ome evidenc e suggest ing that McCall left her job at the hospital at least in part because he r sup ervisors gave her too much work and she simply no longer wanted to work there. But, again, our role is not to reweigh the evidence as

17 factfinders. See Howard, 329 A.3d at 295. The ALJ weighed all the evid ence and found that McCall left the hospital bec ause of her worsening carpal tunnel sym ptoms and becau se the hospital failed to provide certain accommodations. That finding was supported by subst antial evide nce, and the CRB did not err in upholdin g it. III. Conclusion For the foregoing re asons, we affirm the CRB’s decision. So ordered.