United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

S.N., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Seattle, WA, Employer 

__________________________________________ 

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Docket No. 15-1786 

Issued: January 15, 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 

ALEC J. KOROMILAS, Alternate Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On August 26, 2015 appellant filed a timely appeal from a July 30, 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 met her burden of proof to establish a right knee injury 

causally related to her federal employment. 

FACTUAL HISTORY 

On June 18, 2015 appellant, then a 57-year-old city carrier, filed an occupational disease 

claim (Form CA-2) alleging that she had a knee condition casually related to her federal 

employment. On the claim form she indicated that she had been working a lot of overtime and 

 1

 5 U.S.C. § 8101 et seq. 
2

her knee was strained due to overuse.2 There is no indication that appellant stopped working. 

By letter dated June 23, 2015, OWCP requested that she submit additional factual and medical 

evidence with respect to her claim. 

On July 20, 2015 appellant submitted a statement indicating that she attributed her knee 

condition to walking up and down hills and stairs on her route, as well as carrying mail. She 

asserted that she often worked six days per week and her route required six hours of walking. 

Appellant received treatment for right knee pain on June 13, 2015. In a report of that 

date a physician assistant indicated that she had a history of bilateral meniscus tears and likely 

sustained an overuse injury. The record also contains a duty status report (Form CA-17) dated 

June 13, 2015, describing the injury as an overuse injury to the right knee and providing a 

diagnosis of overuse and strain. The June 13, 2015 report contains a handwritten note from 

Dr. Eric Strandberg, a Board-certified family practitioner, in a form report dated June 15, 2015, 

indicating that he had provided work restrictions of eight hours of standing and one half hour of 

walking, with no climbing, or kneeling.3

 Appellant also submitted medical evidence indicating 

treatment by the physician assistant on June 23 and July 8 and 22, 2015. The July 22, 2015 

report indicated that she was released to full duty. 

By decision dated July 30, 2015, OWCP denied the claim for compensation. It found that 

the medical evidence was insufficient to establish the claim, noting that a physician assistant was 

not a physician under FECA. 

LEGAL PRECEDENT 

A claimant seeking benefits under FECA has the burden of establishing the essential 

elements of his or her claim by the weight of the reliable, probative, and substantial evidence, 

including that an injury was sustained in the performance of duty as alleged and that any specific 

condition or disability claimed is causally related to the employment injury.4 

To establish that an injury was sustained in the performance of duty, a claimant must 

submit: (1) medical evidence establishing the presence or existence of the disease or condition 

for which compensation is claimed; (2) a factual statement identifying employment factors 

alleged to have caused or contributed to the presence or occurrence of the disease or condition; 

and (3) medical evidence establishing that the diagnosed condition is causally related to the 

employment factors identified by the claimant.5

 

 2

 The claim form does not identify right or left knee, but it appears from the medical treatment appellant’s claim 

was for a right knee injury. 

3

 The report was also signed by the physician assistant. 

4

 20 C.F.R. § 10.115(e), (f); see Jacquelyn L. Oliver, 48 ECAB 232, 235-36 (1996). 

5 Ruby I. Fish, 46 ECAB 276, 279 (1994). 
3

Causal relationship is a medical question that can generally be resolved only by 

rationalized medical opinion evidence.6

 A physician’s opinion on the issue of whether there is a 

causal relationship between the claimant’s diagnosed condition and the implicated employment 

factors must be based on a complete factual and medical background of the claimant.7

 

Additionally, in order to be considered rationalized, the opinion must be expressed in terms of a 

reasonable degree of medical certainty, and must be supported by medical rationale, explaining 

the nature of the relationship between the diagnosed condition and appellant’s specific 

employment factors.8

 Medical evidence from a physician assistant, this does not constitute 

competent medical evidence as a physician’s assistant is not a physician under 5 U.S.C. 

§ 8101(2).9 

ANALYSIS 

In the present case, appellant has alleged that her work as a city carrier contributed to a 

knee condition. She indicated that her route involved a significant amount of walking, including 

hills, and stairs, as well as carrying packages. To meet her burden of proof, appellant must 

submit rationalized medical evidence that explains the relationship between a diagnosed 

condition and the identified employment factors. 

Medical evidence from a physician assistant, as noted above, is of no probative medical 

value and cannot establish causal relationship. The only medical report that appeared to be 

reviewed by a physician was Dr. Strandberg in CA-17 form reports dated June 13 and 15, 2015, 

but these reports are insufficient to meet appellant’s burden of proof. The report does not 

provide a complete medical history or background. Moreover, there is no medical opinion, 

supported by medical rationale, on causal relationship between a diagnosed right knee condition 

and the identified employment factors. 

For these reasons, the Board finds that appellant did not meet her burden of proof in this 

case.10 

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. 

 6 See Robert G. Morris, 48 ECAB 238 (1996). 

7 Victor J. Woodhams, 41 ECAB 345, 352 (1989). 

8 Id. 

9 George H. Clark, 56 ECAB 162 (2004). 

10 The record indicated that medical evidence was submitted after July 30, 2015. The Board reviews only 

evidence that was before OWCP at the time of the decision on appeal. 20 C.F.R. § 501.2(c)(1). 
4

CONCLUSION 

The Board finds that appellant did not met her burden of proof to establish a right knee 

injury causally related to her federal employment. 

ORDER 

IT IS HEREBY ORDERED THAT the decision of the Office of Workers’ 

Compensation Programs dated July 30, 2015 is affirmed. 

Issued: January 15, 2016 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board