United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

I.H., Appellant 

and 

DEPARTMENT OF THE TREASURY, 

INTERNAL REVENUE SERVICE, 

Richmond, VA, Employer 

__________________________________________ 

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Docket No. 16-0019 

Issued: January 14, 2016 

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

COLLEEN DUFFY KIKO, Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On October 7, 2015 appellant filed a timely appeal from a September 1, 2015 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.2

 

ISSUE 

The issue is whether appellant met her burden of proof to establish an injury causally 

related to a July 15, 2015 employment incident. 

 1

 5 U.S.C. § 8101 et seq. 

2

 The Board notes that, following the issuance of the September 1, 2015 OWCP decision, appellant submitted 

new evidence. The Board is precluded from reviewing evidence which was not before OWCP at the time it issued 

its final decision. See 20 C.F.R. § 501.2(c)(1). 
2

On appeal, appellant contends that OWCP’s decision was erroneous as the incident 

occurred on July 15, 2015 while she was on the job as an employee during her regular duty hours 

between 6:00 a.m. and 2:30 p.m. 

FACTUAL HISTORY 

On July 16, 2015 appellant, a 55-year-old customer service representative, filed a 

traumatic injury claim (Form CA-1) alleging that she injured her left shoulder on July 15, 2015 

in the performance of duty. She stated that she was sitting at her desk working when she felt a 

bite or sting on her arm at approximately 8:30 a.m. Appellant stated that she initially thought 

that it was a mosquito bite. Later, she noted having a burning sensation and the area turned red. 

Appellant advised that she shared this with team members, but her manager was off. The 

employing establishment controverted the claim and indicated that appellant did not lose any 

time from work except for medical appointments and remained on regular duty. 

In a July 23, 2015 letter, OWCP advised appellant of the deficiencies of her claim and 

afforded her 30 days to submit additional evidence and respond to its inquiries. 

In a July 21, 2015 attending physician’s report (Form CA-20) Elizabeth Jackson, a nurse 

practitioner, diagnosed spider bite on the right upper arm. She checked a box marked “no” 

indicating that she did not believe the condition was caused or aggravated by an employment 

activity and noted that the injury did not require hospitalization. Ms. Jackson advised appellant 

that she was able to return to regular duty that same day. 

In a July 21, 2015 duty status report (Form CA-17), Ms. Jackson reiterated her diagnosis 

and noted that appellant was sitting at her desk working on July 15, 2015 when she felt a bite to 

her arm. She reiterated that appellant was released to full-time, regular duty. 

By decision dated September 1, 2015, OWCP denied appellant’s claim as the medical 

evidence was insufficient to establish causal relationship. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA3 has the burden of establishing the essential 

elements of his or her claim, including the fact 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 period of FECA, that an injury4

 was sustained in the performance of duty, as alleged, 

 3 Supra note 1.

4

 OWCP regulations define a traumatic injury as a condition of the body caused by a specific event or incident, or 

series of events or incidents, within a single workday or shift. Such condition must be caused by external force, 

including stress or strain, which is identifiable as to time and place of occurrence and member or function of the 

body affected. 20 C.F.R. § 10.5(ee). 
3

and that any disability or medical condition for which compensation is claimed is causally 

related to the employment injury.5

To determine whether a federal employee has sustained a traumatic injury in the 

performance of duty, it must first be determined whether a “fact of injury” has been established. 

A fact of injury determination is based on two elements. First, the employee must submit 

sufficient evidence to establish that she actually experienced the employment incident at the 

time, place, and in the manner alleged. Second, the employee must submit sufficient evidence, 

generally only in the form of medical evidence, to establish that the employment incident caused 

a personal injury. An employee may establish that the employment incident occurred as alleged 

but fail to show that her condition relates to the employment incident.6 

Causal relationship is a medical issue and the medical evidence generally required to 

establish causal relationship is rationalized medical opinion evidence. 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 the specific employment factors 

identified by the employee.7

 

ANALYSIS 

The Board finds that appellant has not met her burden of proof to establish an injury 

causally related to a July 15, 2015 employment incident. 

OWCP has accepted that the employment incident of July 15, 2015 occurred at the time, 

place, and in the manner alleged. In its September 1, 2015 decision, it denied appellant’s claim 

as the medical evidence was insufficient to establish causal relationship. The issue on appeal is 

whether appellant sustained an injury as a result of the July 15, 2015 employment incident. 

In two reports dated July 21, 2015, Ms. Jackson, a nurse practitioner, diagnosed spider 

bite on the right upper arm and noted that appellant was sitting at her desk working on July 15, 

2015 when she felt a bite to her arm. These documents do not constitute competent medical 

evidence because a nurse practitioner is not a “physician” as defined under FECA.8

 As such, this 

evidence is also insufficient to meet appellant’s burden of proof. Therefore, the Board finds that 

the medical evidence is insufficient to establish that the claimed bite was a medical diagnosis 

caused by the employment incident. 

 5 See T.H., 59 ECAB 388 (2008). See also Steven S. Saleh, 55 ECAB 169 (2003); Elaine Pendleton, 40 ECAB 

1143 (1989). 

6 Id. See Shirley A. Temple, 48 ECAB 404 (1997); John J. Carlone, 41 ECAB 354 (1989). 

7 Id. See Gary J. Watling, 52 ECAB 278 (2001). 

8

 5 U.S.C. § 8101(2); Paul Foster, 56 ECAB 208 (2004) (a nurse practitioner is not a physician under FECA). 

See also Charley V.B. Harley, 2 ECAB 208, 211 (1949) (where the Board held that medical opinion, in general, can 

only be given by a qualified physician). 
4

The Board notes that, pursuant to OWCP procedures, where the condition reported is a 

minor one, such as a burn, laceration, insect sting, or animal bite, which can be identified on 

visual inspection by a lay person, a case may be accepted without a medical report and no 

development of the case need be undertaken, if the injury was witnessed or reported promptly, 

no dispute exists as to the occurrence of the injury, and no time was lost from work due to 

disability.9

In the instant case, the record does not contain a sufficient description of the claimed bite 

to warrant application of the minor injury exception to the requirement for medical evidence. 

Although appellant stated that she reported this to coworkers, there are no statements indicating 

contemporaneous knowledge of this incident. Furthermore, the employing establishment 

controverted the claim. The most contemporaneous description of this incident is on appellant’s 

traumatic injury claim form where she noted feeling a sting or bite on her arm. However, at that 

time she did not identify which arm and she did not clearly identify where on her arm the bite or 

sting occurred. This description is imprecise and, since there are no witness statements and the 

employing establishment controverted the claim, the injury is not sufficiently described in the 

evidence of record to support acceptance of an insect or spider bite without a medical report.10

On appeal, appellant contends that OWCP’s decision was erroneous because the incident 

occurred on July 15, 2015 while she was on the job as an employee during her regular duty hours 

between 6:00 a.m. and 2:30 p.m. As she has not submitted any probative medical evidence to 

support her allegation that she sustained an injury related to the July 15, 2015 employment 

incident, the Board finds that appellant did not meet her burden of proof to establish a claim for 

compensation. 

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 an injury 

causally related to a July 15, 2015 employment incident. 

 9

 Federal (FECA) Procedure Manual, Part 2 -- Claims, Initial Development of Claims, Chapter 2.800.6(a) 

(June 2011). M.A., Docket No. 13-1630 (issued June 18, 2014). 

10 See E.T., Docket No. 14-1087 (issued September 5, 2014). 
5

ORDER 

IT IS HEREBY ORDERED THAT the September 1, 2015 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: January 14, 2016 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board