United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

E.T., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

West Haven, CT, Employer 

__________________________________________ 

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Docket No. 15-0839 

Issued: July 6, 2015 

Appearances: Case Submitted on the Record

Appellant, pro se 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On March 2, 2015 appellant filed a timely appeal from a February 2, 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. 

ISSUE 

The issue is whether appellant sustained an injury on November 25, 2014 in the 

performance of duty. 

FACTUAL HISTORY 

On November 26, 2014 appellant, then a 64-year-old labor custodian, filed a traumatic 

injury claim alleging that on November 25, 2014 he injured his right side and right lower back 

 1

 5 U.S.C. § 8101 et seq. 
2

when a coworker put him in a headlock. He did not stop work. The employing establishment 

did not controvert the claim. 

In a return to work slip dated November 26, 2014, a nurse practitioner indicated that 

appellant could resume work with restrictions of no lifting over 20 pounds for one week. 

By letter dated December 16, 2014, OWCP requested that appellant submit a detailed 

report from his attending physician addressing the causal relationship between any diagnosed 

condition and the identified work incident. It advised him that reports from nurse practitioners 

and physician assistants did not constitute competent medical evidence under FECA. 

In a duty status report dated December 16, 2014, Dr. Rachel E. Laff, a Board-certified 

internist, diagnosed a musculoskeletal strain and checked “yes” that the history of injury given 

by appellant corresponded to that on the form of him being put in a headlock. She opined that he 

could perform light duty pending completion of physical therapy. Dr. Laff provided work 

restrictions. 

By decision dated February 2, 2015, OWCP denied appellant’s claim after finding that 

the medical evidence was insufficient to show that he sustained a diagnosed condition as a result 

of the accepted November 25, 2014 employment incident. It found that the signature on the 

December 16, 2014 duty status report was illegible and thus it could not determine whether it 

constituted competent medical evidence. OWCP further found that the December 16, 2014 duty 

status report was insufficient to show that appellant sustained a specific diagnosed condition. 

On appeal appellant argues that Dr. Laff cosigned the medical reports he submitted for 

consideration. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA2 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 filed within the applicable time 

limitation; that an injury was sustained while in the performance of duty as alleged; and that any 

disability and/or specific condition for which compensation is claimed are 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 on a traumatic injury or an occupational disease.4

To determine whether an employee sustained a traumatic injury in the performance of 

duty, OWCP must determine whether “fact of injury” is established. First, an employee has the 

burden of demonstrating the occurrence of an injury at the time, place, and in the manner 

alleged, by a preponderance of the reliable, probative, and substantial evidence.5

 Second, the 

 2

 5 U.S.C. § 8101 et seq. 

3 Alvin V. Gadd, 57 ECAB 172 (2005); Anthony P. Silva, 55 ECAB 179 (2003). 

4 See Elizabeth H. Kramm (Leonard O. Kramm), 57 ECAB 117 (2005); Ellen L. Noble, 55 ECAB 530 (2004). 

5 David Apgar, 57 ECAB 137 (2005); Delphyne L. Glover, 51 ECAB 146 (1999). 
3

employee must submit sufficient evidence, generally only in the form of medical evidence, to 

establish a causal relationship between the employment incident and the alleged disability and/or 

condition for which compensation is claimed.6 An employee may establish that the employment 

incident occurred as alleged, but fail to show that his or her disability and/or condition relates to 

the employment incident.7

ANALYSIS 

Appellant alleged that he sustained an injury to his right side and lower back on 

November 25, 2014 when a coworker placed him in a headlock. OWCP accepted that the 

incident occurred at the time, place, and in the manner alleged. The issue is whether the medical 

evidence establishes that appellant sustained an injury as a result of this incident. 

The Board finds that appellant has not established that the November 25, 2014 

employment incident resulted in an injury. The determination of whether an employment 

incident caused an injury is generally established by medical evidence.8

Appellant submitted a November 26, 2014 disability certificate from a nurse practitioner. 

However, a nurse or nurse practitioner is not considered a “physician” under FECA and thus 

cannot render a medical opinion.9

In a form report dated December 16, 2014, Dr. Laff diagnosed a musculoskeletal strain 

and checked “yes” that the history of injury obtained from appellant corresponded to that on the 

form of appellant having been placed in a headlock. The Board has held, however, that an 

opinion on causal relationship which consists only of a physician checking “yes” to a medical 

form question on whether the claimant’s condition was related to the history given is of little 

probative value. Without explanation or rationale for the conclusions reached, such report is 

insufficient to establish causal relationship.10 Dr. Laff did not provide any rationale for her 

opinion and thus her form report is insufficient to meet appellant’s burden of proof. 

While OWCP determined that the signature on the December 16, 2014 report from 

Dr. Laff was illegible and thus was not competent medical evidence, it further found that the 

report itself did not adequately describe a diagnosed condition. Dr. Laff failed to explain the 

mechanism by which appellant being put in a headlock caused a musculoskeletal strain or 

specifically identify the area of the body that sustained the strain. There is also no indication in 

the record that the remaining treatment note submitted prior to OWCP’s February 2, 2015 

decision was cosigned by Dr. Laff. 

 6 Gary J. Watling, 52 ECAB 278 (2001); Shirley A. Temple, 48 ECAB 404, 407 (1997). 

7 Id.

8 Lois E. Culver (Clair L. Culver), 53 ECAB 412 (2002). 

9

 5 U.S.C. § 8101(2); Vincent Holmes, 53 ECAB 468 (2002). 

10 Cecelia M. Corley, 56 ECAB 662 (2005); Deborah L. Beatty, 54 ECAB 334 (2003) (the checking of a box 

“yes” in a form report, without additional explanation or rationale, is insufficient to establish causal relationship). 
4

An award of compensation may not be based on surmise, conjecture, speculation, or upon 

appellant’s own belief that there is a causal relationship between his claimed condition and his 

employment.11 The record does not contain a physician’s report in which the physician reviewed 

those factors of employment identified by him as causing his condition, take these factors into 

consideration, consider the findings upon examination, consider the medical history, explain how 

employment factors caused or aggravated any diagnosed condition, or present medical rationale 

in support of his opinion.12 Appellant failed to submit such evidence and therefore failed to meet 

his 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 and 

20 C.F.R. §§ 10.605 through 10.607. 

CONCLUSION 

The Board finds that appellant has not established that he sustained an injury on 

November 25, 2014 in the performance of duty. 

ORDER 

IT IS HEREBY ORDERED THAT the February 2, 2015 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: July 6, 2015 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board 

 11 D.E., 58 ECAB 448 (2007); George H. Clark, 56 ECAB 162 (2004); Patricia J. Glenn, 53 ECAB 159 (2001). 

12 D.D., 57 ECAB 734 (2006); Robert Broome, 55 ECAB 339 (2004).