is not an employee within the meaning of the Act, she is not entitled to compensation for wage loss or permanent impairment under the other provisions of the Act.

The Board notes that study of the appeal papers filed on November 26, 1982 reveals two appellants: the employee, and his sister and donor of the kidney. The employee's sister does not represent him and, as noted above, is not a federal employee. Under 5 U.S.C. section 8149, the Board has the authority "to hear and . . . make final decision on appeals taken from determinations and awards with respect to claims of employees." (Emphasis added). The Act limits the Board to hearing only appeals of employees from final decisions of the Office.5 Therefore, the employee's sister is not a proper appellant for purposes of appeal before the Board and the Board lacks jurisdiction to entertain any appeal which she has filed. The case has been improperly docketed under her name and her appeal must be dismissed.

The decision of the Office of Workers' Compensation Programs dated December 4, 1981 is hereby affirmed. It is further ordered that the appeal filed by the employee's sister be and hereby is dismissed.

5 Deborah V. Lanham, 32 ECAB 137. Employee representatives and designated beneficiaries and dependents have appeal rights, based on specific provisions not involved in this case.

In the Matter of FAUSTINO LAZO and

DEPARTMENT OF THE NAVY,

NAVAL SHIP REPAIR FACILITY, Subic Bay, Philippines

Medical opinions, effect of conflict in

The Board found that the case was not in posture for decision due to a conflict in the medical evidence. The issue was whether appellant's arthritis, pulmonary and hypertensive cardiovascular conditions were causally related to factors of his federal employment. The extensive report of appellant's treating physician supported causal relationship between the diagnosed conditions and factors of his employment as a pipecoverer and insulator. On the other hand, a Board-certified surgeon who reviewed appellant's records, concluded there was no relationship between appellant's osteoarthritis, hypertensive cardiovascular disease and respiratory problems and his federal employment. Therefore, the case was remanded to the Office for referral of appellant, along with his case record and statement of accepted facts, to an appropriate specialist or specialists for examination and resolution of the causal relationship issue.

Docket No. 83-286; Submitted on the Record;

Issued February 18, 1983

Before E. GERALD LAMBOLEY, WILLIE T. C. THOMAS, DAVID S. GERSON

The issue is whether appellant's arthritis, pulmonary and hypertensive cardiovascular conditions are causally related to factors of his federal employment.

On April 11, 1980 appellant filed a notice of occupational disease alleging that his "chest pains, shortness of breath, hypertensive cardiovascular disease and degenerative osteoarthritis of the lumbar vertebrae" were caused by his exposure to asbestos dust and by the awkward positions in which he had to work as a pipecoverer and insulator. He retired on disability on the same date due to the above-mentioned conditions.

A job description submitted by the employing establishment indicates that as a pipecoverer and insulator appellant was exposed to asbestos and that he was required to kneel, crouch, stoop, climb and work in a cramped position.

In response to an Office of Workers' Compensation Programs request for medical evidence, appellant submitted a June 14, 1982 report by Dr. Ernesto P. Nuguid, who had been treating him since February 23, 1979. That report stated the following:

"Mr. Lazo's nature of work essentially consists of repeated and constant exertions of excessive physical efforts in the repair, including dismantling, fabrication and installation of miscellaneous pipings for the water supply, fire mains, fuel distributions, CO2 systems, engine and boiler pipings, drainage and sewerage systems, etc. of the various ships of the PACFLEET ships. For every piece of work, from the removal of deteriorated or damaged pipings in various stages of dismantling, fabrication to its location on the ships necessitates the heavy functional exertions of constant and prolonged bending and stooping, kneeling or crawling, crouching to be able to do his work. His usual work place being in hard-to-reach spaces of the ships when test fitting and installing the pipings for main engines, generators, fire mains, water supply, fuel distributions, CO2 systems, drainage and sewerage normally located in the very cramped spaces of the bilges, and double bottoms, compartments, inside tanks, essentially required the heavy lifting while bending or stooping or twisted position or kneeling, squatting, sitting while bending straining to adjust his body to the closed and tight spaces to be able to do his assigned work, while exposed to hot work environment, vibrations, poor lighting, fumes and smoke.

"His promotion to pipecoverer and insulator required him to work with all forms of asbestos to cover and insulate hot water and

steam lines of boilers, galleys, heaters, etc. The asbestos and protective clothing, with the asbestos dusts and fibers flying and floating visibly in patient Lazo's work area. He had worked with asbestos long before his designation to pipecoverer when ripping asbestos to do work with hot water and steam lines and had to replace the asbestos insulation after piping repairs. It was his prior experience with asbestos work that he was promoted to pipecoverer and insulator. Similar to his pipefitter job and as a pipecoverer and insulator, he had to exert heavy physical work of repeated and constant bending and stooping, kneeling, crouching, seated on the deck while bending and twisting around to fit his body in the cramped work spaces to do his work.

"Degenerative osteoarthritis of the lumbar vertebrae develops so slowly that it takes years from the time of onset to that time the symptoms appear and be felt until the manifestations become ultimately disabling. The spinal cord must bend and flex without the vertebrae slipping out of alignment. Normal movements can cause the disc casings to become worn and if the normal movements become a constant and repeated bending and stooping, kneeling, crouching, heavy lifting while in the bending, stooping or twisted position, seated on the deck while bending and twisting around to adjust to the work in the cramped work spaces, which were essential movements required and executed to be able to perform his job, caused the disc casings and spinal cord to become highly worn out and heavily damaged, thus causing the vertebral margins to rub against the next vertebral bone, trauma is undeniable.

"With that constant trauma the disc casings and the synovial fluid that protects the marginal ends of the joints diminished to an amount that its protective ability becomes nil thus secondary degenerative arthropathy significantly sets in.

"Degenerative osteoarthritis is a progressive and irreversible process. The secondary type of degenerative osteoarthritis in the case of patient Faustino F. Lazo finally results in degeneration of the cartilages that joins the vertebral bones and followed by the uncontrolled hypertrophy of the bones at its articular margins account for the persistent and restricting pains along his lumbosacral joints concomitant with the loss of 20° on forward flexion, 10° loss on backward extension, and 10° loss on each side during lateral flexion.

"In the disassembly, fitting of pipings for reassembly and installations in the hard-to-reach, cramped and low level, hot and poorly ventilated work spaces required patient Lazo to resort to awkward positions of constant kneeling, crawling, and heavy lifting while in these heavy physical exertive positions, exerted his body weight and the lifted weight thrusts on his knees from a low positive to a

strong joint separation force. The combined effects of tension in the muscle and thrust acting on the joint surfaces created conditions conducive to joint injury. Excessive kneeling, to be able to cope up with his job in the tight and low spaces most probably precipitated joint separation force of substantial magnitude in the synovial linings of the knee joints.

"Asbestosis is a form of pneumoconiosis and is an occupational disease due to the exposure and inhalation of asbestos dust over a long period, irritating the lymphatic of the lungs. Simple pneumoconiosis or asbestosis shows up late or not at all on most simple lung function tests and chest x-rays. As the disease progresses, the symptoms that resemble bronchitis become chronic coughing with shortness of breath accompanied by chest pains. Small scars on the lungs develop and coalesce into large masses of scar tissue to the point where they may occupy half of the lung, ripping the air sac wall. In the progress of asbestosis over a 5-20 year period, the group of fibers that accumulate in the lungs are surrounded with a thick wall of scar tissues causing the lungs to become inelastic and unable to contract.

"Since the disease reduces the capacity of the lungs to hold air, the body has to work harder to fill them. Asbestos particles concentrated in the lower part of lungs shrinks and the pleura of the lungs may become inflamed. The lung damage resulting from the disease is irreversible.

"Patient Lazo was essentially assigned enclosed and cramped work spaces mostly poorly ventilated, temperature mostly over 95° inhaling fumes from welding processes, obnoxious odor of corrosion and waste water when in sewerage tanks and double bottoms and bilges. Prior to stringent safety precautions imposed in the middle part of 1980 when working with asbestos, patient Lazo had worked with asbestos since he started work as a pipefitter, only to be formally given the asbestos assignment when he was promoted to pipecoverer and insulator. The foregoing working conditions coupled with asbestos work and the subsequent inhalation of asbestos fibers floating in and around the work area, gradually precipitated the constant accumulation of asbestos fibers in his lung, which reduces patient Lazo's lung capacity and the normal interchange of oxygen and carbon dioxide placed additional and steady load on his cardiovascular hypertensive condition, rendering the disease unresponsive to hypotensive therapy.

"As a physician with extensive training and experience in Industrial Medicine has verified that patient Lazo's essential exposure to the above environmental conditions for more than fourteen (14) years were necessarily interrelated and the subsequent and progressive

interactions caused, precipitated and aggravated patient Lazo's degenerative osteoarthritis, knee joints pains, asbestosis concomitant with cardiovascular hypertensive disease."

The Office referred appellant's case record to Dr. Herbert K. N. Luke, a Board-certified surgeon, for review and opinion on "whether employment factors were in any way responsible, either causing, precipitating or aggravating,” his claimed conditions . . . Dr. Luke responded with the following August 26, 1982 report:

"The patient was employed as a pipecoverer and insulator from 1965 to 1980. Later he developed signs and symptoms of degenerative osteoarthritis involving the back and the right knee. The medical file mentions arthritic changes of the fingers also. On review of his occupation, I note that he also handles asbestos, although not daily in his job.

"Review of the medical file indicates a finding of hypertension considered slight to more than slight.

"In the file there is no documentation of trauma to the low back or to the extremities, including the right knee. There is no documented history or findings of asbestosis.

"The x-ray report of 2-8-80 shows normal disc spaces in the low back. There is spondylosis or spurs, described as mild degeneration compatible with his age.

"With the lack of any trauma as noted in the medical file, it is evident that the patient's degenerative osteoarthritis is simply that of the ageing process of degeneration which afflicts all of us. There is no indication that his employment as a pipecoverer and insulator caused, aggravated or accelerated his back condition. Likewise, there is no evidence of asbestosis. The patient's hypertensive cardiovascular disease consists of degenerative changes of the vascular system. There is no indication that his employment caused or aggravated his condition.

"In conclusion, his medical claim that his work as a pipecoverer and insulator from 1965 to 1980 caused or aggravated his osteoarthritis, hypertensive cardiovascular disease and respiratory problems, cannot be substantiated."

By compensation order dated November 1, 1982 the Office rejected appellant's claim on the ground that he had failed to meet his burden of proof.

The Board finds that the case is not in posture for decision due to a conflict in the medical evidence.

The extensive report of Dr. Nuguid, appellant's treating physician, supports causal relationship between the diagnosed conditions and factors of his employment as a pipecoverer and insulator. On the other