United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

J.P., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Tucson, AZ, Employer 

__________________________________________ 

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Docket No. 14-87 

Issued: March 14, 2014 

Appearances: Case Submitted on the Record

Appellant, pro se 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

RICHARD J. DASCHBACH, Chief Judge 

PATRICIA HOWARD FITZGERALD, Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On October 17, 2013 appellant filed a timely appeal from an April 22, 2013 merit 

decision of the Office of Workers’ Compensation Programs (OWCP) denying her claim for 

compensation. 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 established that she sustained a traumatic injury in the 

performance of duty on February 13, 2012. 

FACTUAL HISTORY 

On February 21, 2012 appellant, then a 56-year-old sales, service, and distribution 

associate, filed a traumatic injury claim (Form CA-1) alleging that she sustained an injury to her 

left arm and upper back in the performance of duty on February 13, 2012. She stated that her 

 1

 5 U.S.C. § 8101 et seq. 
2

injury occurred when a 68-pound parcel fell on her left hand and arm from atop a six-foot cage. 

The employing establishment checked a box indicating that appellant was injured in the 

performance of duty. 

Appellant submitted a form report dated March 6, 2012, signed by a physician’s assistant. 

Appellant also submitted physical therapy notes, signed by physical therapists, dating 

from March 28 through May 4, 2012. These notes contained a signed referral from Dr. Surekha 

Bandlamuri, a Board-certified internist, noting her diagnosis of cervicalgia and recommending 

physical therapy three times per week for four weeks. 

In a report dated April 17, 2012, Dr. Bandlamuri diagnosed appellant with cervicalgia, 

unspecified backache, and pain in the joint of the shoulder region. On examination, she noted 

that appellant’s left shoulder had no pain and that she was not experiencing muscle weakness, 

swelling, bruising, tingling or numbness. 

On May 17, 2012 Dr. Bandlamuri repeated her prior diagnoses and stated that appellant’s 

injury occurred in February due to a fall. She stated that appellant’s left arm and neck did not 

bother her anymore and that her neck had normal range of motion. Dr. Bandlamuri noted that 

appellant was still experiencing headaches and cervicalgia and referred her for further physical 

therapy for the latter condition. 

By letter dated July 26, 2012, OWCP informed appellant that the evidence of record was 

insufficient to establish her claim. It afforded her 30 days to submit additional evidence and to 

respond to its inquiries, noting that “pain” is not a valid diagnosis supportive of a claim for 

compensation, and that she had not submitted rationalized medical opinion evidence to establish 

that she had been diagnosed with a condition resulting from the incident of February 13, 2012. 

Appellant did not respond. 

By decision dated October 4, 2012, OWCP denied appellant’s claim. However, it 

accepted that appellant had filed a timely claim, that the incident occurred, that a medical 

condition had been diagnosed, and that she was within the performance of duty at the time of the 

incident. OWCP found that she did not submit rationalized medical opinion evidence to 

establish that the diagnosed condition of cervicalgia was causally related to the February 13, 

2012 incident. 

On October 28, 2012 appellant requested an oral hearing before an OWCP hearing 

representative. 

In an undated statement, appellant alleged that she had not received the development 

letter of July 26, 2012 and noted that she had spoken to several OWCP employees in an attempt 

to contact the claims examiner who wrote the October 4, 2012 decision. 

In a report dated October 25, 2012, Dr. Bandlamuri diagnosed appellant with reflux 

esophagitis, cervicalgia and pain in the joint of the shoulder region. She noted that appellant’s 

neck and shoulder pain had resolved and that appellant requested that Dr. Bandlamuri complete 

paperwork in support of her claim. 
3

By letter dated November 2, 2012, Dr. Bandlamuri reviewed appellant’s history of 

diagnosis and treatment, stating that appellant’s pain of the neck and left shoulder occurred due 

to an injury at work on February 13, 2012 when she attempted to block a 68-pound box from 

falling on her with her left hand. She noted that, on March 2, 2012, she had reviewed the results 

of x-rays of the cervical spine and left shoulder taken on February 14, 2012, which revealed 

abnormal straightening of the spine and minor degenerative changes, but no evidence of trauma. 

Dr. Bandlamuri stated that appellant had full range of motion of her left shoulder on this date 

with no pain and tenderness in the left upper back. She stated that appellant returned on 

March 6, 2012, with left full range of motion discomfort and muscle tightness, and again on 

April 17, 2012 with left upper back tenderness and no pain with full range of motion of the left 

shoulder. On October 15, 2012 appellant noted that her left shoulder and back pain had 

improved. On October 23, 2012 she stated that she had heavy shooting pain of the right arm, as 

well as tightening of the left lateral neck, but Dr. Bandlamuri found that she was asymptomatic at 

the time of examination. Dr. Bandlamuri told appellant that her neck pain was due to spasm and 

tightening of her sternocleidomastoid muscle and advised her to use heat and Ibuprofen. 

In a statement dated October 28, 2012, appellant described the effects of her injury and 

her actions in the immediate aftermath of the traumatic incident of February 13, 2012. She noted 

that her arm, neck, head, and upper back began to hurt only after her shift ended, but that she had 

notified her supervisor several hours after it occurred. Appellant stated that she did not sustain 

any injury to herself between February 13, 2012 and the date she first saw her physician, 

February 14, 2012. 

In a record of an oral hearing held on February 14, 2013, the hearing representative 

expressed her opinion that OWCP had incorrectly accepted that the evidence established the 

medical component of fact of injury. She stated that appellant had submitted only a diagnosis of 

cervicalgia from her physician, which meant neck pain, and that because pain was not an 

acceptable diagnosis, appellant had not established a diagnosed medical condition. Appellant 

noted that she had not received the development letter of July 26, 2012, and that she had not 

known that her claim had a $1,500.00 payment limit without formal adjudication. She stated that 

she thought her physician and therapist had been sending OWCP appropriate information. 

Appellant had retired from the employing establishment in the last few weeks. The hearing 

representative noted that even with an acceptable diagnosis, appellant would still need to submit 

a report from a physician explaining how her diagnosis was causally related to the employment 

incident, and that Dr. Bandlamuri’s May 17, 2012 statement contradicted the history of injury 

given by claimant because it stated that her injury resulted from a fall. An agency representative 

attended the hearing, but did not testify. 

By report dated February 26, 2013, Dr. Bandlamuri noted that appellant’s symptoms 

were consistent with her statement of what had occurred at work. She repeated her diagnoses of 

cervicalgia, unspecified backache, left shoulder pain, unspecified musculoskeletal disorders and 

symptoms referable to the neck and spasm of muscle. Dr. Bandlamuri stated that appellant had 

sustained her injury as a result of an incident at work. 

In a statement dated March 13, 2013, appellant noted that Dr. Bandlamuri’s May 17, 

2012 report was in error and that Dr. Bandlamuri had told appellant that she meant to write that a 

package had fallen on appellant. She stated that she had not been previously informed of the 
4

$1,500.00 limit to medical expenses and that the employing establishment had told her that 

OWCP should be paying her bills if her physician was still treating her. Appellant noted that she 

had not claimed disability and that she had attempted to keep her costs low. 

On March 14, 2013 the employing establishment sent a letter to OWCP noting that it was 

challenging appellant’s claim because she had not established that her diagnosis was causally 

related to the traumatic event of February 13, 2012. 

By decision dated April 22, 2013, the hearing representative found that OWCP had 

mistakenly accepted that appellant had been diagnosed with a condition in its October 4, 2012 

decision, and affirmed OWCP’s earlier denial of compensation as modified. She noted that 

appellant had not submitted any medical evidence with a diagnosis other than “pain,” and that 

findings of pain do not satisfy the medical aspect of the fact of injury determination. 

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 timely filed within the applicable time 

limitation period of FECA, that an injury3 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

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 he or 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 his or her condition relates to the employment incident.5

Whether an employee sustained an injury in the performance of duty requires the 

submission of rationalized medical opinion evidence.6

 The opinion of the physician must be 

based on a complete factual and medical background of the employee, must be one of reasonable 

 2

 5 U.S.C. §§ 8101-8193. 

3

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

or series of events of 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). 

4 T.H., 59 ECAB 388, 393 (2008); see Steven S. Saleh, 55 ECAB 169, 171-72 (2003); Elaine Pendleton, 40 

ECAB 1143, 1145 (1989). 

5 Id. See Shirley A. Temple, 48 ECAB 404, 407 (1997); John J. Carlone, 41 ECAB 354, 356-57 (1989). 

6 See J.Z., 58 ECAB 529, 531 (2007); Paul E. Thams, 56 ECAB 503, 511 (2005). 
5

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 The weight of the medical evidence is determined by its reliability, its probative 

value, its convincing quality, the care of analysis manifested and the medical rationale expressed 

in support of the physician’s opinion.8

ANALYSIS 

On February 21, 2012 appellant filed a claim alleging that she sustained left arm and 

upper back injuries due to an incident at work on February 13, 2012. She noted that her injury 

occurred when a 68-pound parcel fell on her left hand and arm from atop a six-foot cage. By 

decision dated April 22, 2013, an OWCP hearing representative denied appellant’s claim, finding 

that she had not established a diagnosed condition due to the accepted incident. 

The Board finds that appellant did not meet her burden of proof to establish her claim for 

a February 13, 2012 work-related injury because she did not submit sufficient medical evidence 

to establish a firm medical diagnosis due to the accepted incident. Appellant submitted reports 

from Dr. Bandlamuri. In a report dated February 26, 2013, Dr. Bandlamuri diagnosed appellant 

with cervicalgia, unspecified backache, left shoulder pain, unspecified musculoskeletal disorders 

and symptoms referable to the neck and spasm of muscle. She stated that appellant had 

sustained her injury as a result of an incident at work. These assessments were consistent with 

Dr. Bandlamuri’s prior reports. 

The Board has held that pain and spasm are generally descriptions of symptoms and are 

not, in themselves, considered firm medical diagnoses.9 Dr. Bandlamuri’s description of 

cervicalgia, unspecified backache, left should pain, and muscle spasm are not sufficient to 

establish a firm medical diagnosis related to the accepted incident at work. On repeated 

examination, she was unable to find evidence of traumatic injury to appellant, and unable to offer 

a firm medical diagnosis regarding appellant’s conditions. On March 2, 2012 Dr. Bandlamuri 

reviewed the results of x-rays of the cervical spine and left shoulder taken on February 14, 2012, 

which revealed no evidence of trauma. She stated that appellant had full range of motion of her 

left shoulder on this date with no pain and tenderness in the left upper back. In a report dated 

April 17, 2012, Dr. Bandlamuri noted that appellant’s left shoulder had no pain and that she was 

not experiencing muscle weakness, swelling, bruising, tingling or numbness. In a report dated 

May 17, 2012, she stated that appellant’s left arm and neck did not bother her anymore and that 

her neck had normal range of motion. Dr. Bandlamuri did not offer a firm medical diagnosis for 

appellant’s condition, but instead offered only assessments of pain and spasm. Therefore, the 

Board finds the reports of Dr. Bandlamuri insufficient to establish appellant’s claim. 

 7 I.J., 59 ECAB 408, 415 (2008); Victor J. Woodhams, 41 ECAB 345, 352 (1989). 

8 James Mack, 43 ECAB 321, 329 (1991). 

9 See B.P., Docket No. 12-1345 (issued November 13, 2012) (regarding pain); C.F., Docket No. 08-1102 (issued 

October 10, 2008) (regarding pain); J.S., Docket No. 07-881 (issued August 1, 2007) (regarding spasm). 
6

Appellant submitted physical therapy notes dated from March 28 through May 4, 2012, 

along with a form report signed only by a physician’s assistant dated March 6, 2012. Physical 

therapists and physician’s assistants are not physicians as defined under FECA. Therefore, their 

medical reports do not qualify as probative medical evidence supportive of a claim for federal 

workers’ compensation.10 As the submitted physical therapy notes and form report were not 

countersigned by a physician, they are not probative medical evidence. 

The Board finds that appellant did not submit sufficient medical evidence providing a 

firm diagnosis or a rationalized explanation as to how the accepted incident physiologically 

caused a neck and left arm condition. Appellant therefore failed to establish that she had a left 

arm and upper back condition resulting from the February 13, 2012 employment incident. 

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 did not meet her burden of proof to establish that she 

sustained a left arm and upper back injury on February 13, 2012 in the performance of duty. 

 10 See 5 U.S.C. § 8101(2); Vickey C. Randall, 51 ECAB 357, 360 n.4 (2000) (regarding physical therapists); 

Lyle E. Dayberry, 49 ECAB 369, 372 (1998) (regarding physicians’ assistants). 
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ORDER 

IT IS HEREBY ORDERED THAT the Office of Workers’ Compensation Programs’ 

decision dated April 22, 2013 is affirmed. 

Issued: March 14, 2014 

Washington, DC 

 

 Richard J. Daschbach, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia Howard Fitzgerald, Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board