United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

S.A., Appellant 

and 

DEPARTMENT OF HOMELAND SECURITY, 

TRANSPORTATION SECURITY 

ADMINISTRATION, Chicago, IL, Employer 

__________________________________________ 

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Docket No. 16-0073 

Issued: February 2, 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 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On October 16, 2015 appellant filed a timely appeal from a September 21, 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 an injury causally 

related to a March 8, 2014 employment incident. 

FACTUAL HISTORY 

On March 19, 2014 appellant, a 29-year-old transportation security officer, filed a 

traumatic injury claim (Form CA-1) alleging that she sustained a back injury on March 8, 2014 

                                                             1

 5 U.S.C. § 8101 et seq. 
2

while in the performance of duty. She stated that she was checking a bag and injured her back 

while lifting it from the rollers to the screening table. The employing establishment did not 

indicate that appellant stopped work. 

Appellant submitted a prescription dated March 14, 2014 referring her to physical 

therapy for a diagnosis of back pain and physical therapy notes dated March 24 through May 15, 

2014 from Melissa Strzelinski, a physical therapist, who diagnosed lower back pain from a workrelated injury. 

In a June 4, 2014 letter, OWCP indicated that when appellant’s claim was received it 

appeared to be a minor injury that resulted in minimal or no lost time from work and, based on 

these criteria and because the employing establishment did not controvert continuation of pay 

(COP) or challenge the case, payment of a limited amount of medical expenses was 

administratively approved. It stated that it had reopened the claim for consideration because the 

medical bills had exceeded $1,500.00. OWCP requested additional evidence and afforded 

appellant 30 days to respond to its inquiries. 

Appellant submitted a narrative statement dated June 20, 2014 reiterating the factual 

history of her claim and a March 14, 2014 report from Dr. Elyse Esrig, a Board-certified 

internist, who diagnosed low back pain. Dr. Esrig asserted that appellant was lifting a bag at 

work when she felt a pop and experienced back pain the next morning. Appellant also submitted 

a normal x-ray of the lumbar spine dated March 18, 2014 and an x-ray of the thoracic spine dated 

March 18, 2014 which revealed mild right scoliosis. 

By decision dated July 18, 2014, OWCP denied appellant’s claim because the medical 

evidence submitted failed to establish a diagnosed condition causally related to the March 8, 

2014 employment incident. 

On June 24, 2015 appellant requested reconsideration and submitted a June 11, 2015 

report from Dr. Esrig who reiterated her diagnosis of low back pain. Dr. Esrig explained that 

appellant’s back pain diagnosis “existed and what she did at work,” was caused by “lifting a 

heavy bag at work.” She pointed out that the strain could have been “muscular, facet joint, disc, 

or other.” 

By decision dated September 21, 2015, OWCP denied modification of its prior decision. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA 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 injury2 was sustained in the performance of duty, as alleged, 

                                                             2

 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.3

 

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 his or her condition relates to the employment incident.4 

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.5

 

ANALYSIS 

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

causally related to a March 8, 2014 employment incident. 

OWCP has accepted that the employment incident of March 8, 2014 occurred at the time, 

place, and in the manner alleged. The issue is whether appellant sustained an injury as a result. 

The Board finds that appellant did not meet her burden of proof to establish that she sustained an 

injury related to the March 8, 2014 employment incident. 

In her reports, Dr. Esrig diagnosed low back pain. She explained that appellant’s back 

pain diagnosis was caused by lifting a bag at work and the strain could have been “muscular, 

facet joint, disc, or other.” The Board finds that Dr. Esrig’s diagnosis of low back pain is a 

description of a symptom rather than a clear diagnosis of the medical condition.6

 The Board 

further finds that Dr. Esrig’s indication of a “muscular, facet joint, disc, or other” type of strain is 

not a firm diagnosis. Therefore, the reports from Dr. Esrig are insufficient to establish a medical 

diagnosis in connection with the injury. 

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

1143 (1989). 

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

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

6

 The Board has consistently held that pain is a symptom, rather than a compensable medical diagnosis. See P.S., 

Docket No. 12-1601 (issued January 2, 2013); C.F., Docket No. 08-1102 (issued October 10, 2008). 
4

Other medical evidence submitted by appellant, such as the March 18, 2014 x-rays, are of 

limited probative value as they do not address whether appellant’s employment caused a 

diagnosed condition.7

Appellant also provided physical therapy notes dated March 24 through May 15, 2014 

from Ms. Strzelinski, a physical therapist, who diagnosed lower back pain from a work-related 

injury. These documents do not constitute competent medical evidence as they are not from a 

physician.8 

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

establish that she has a diagnosed medical condition causally related to the March 8, 2014 work 

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 has not met her burden of proof to establish an injury 

causally related to a March 8, 2014 employment incident. 

                                                             7 See Jaja K. Asaramo, 55 ECAB 200 (2004) (medical evidence that does not offer any opinion regarding the 

cause of an employee’s condition is of diminished probative value on the issue of causal relationship). 

8 A.C., Docket No. 08-1453 (issued November 18, 2008) (records from a physical therapist do not constitute 

competent medical opinion in support of causal relation; a physical therapist is not a physician as defined under 

FECA). See 5 U.S.C. § 8101(2). This subsection defines the term “physician.” 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). 
5

ORDER 

IT IS HEREBY ORDERED THAT the September 21, 2015 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: February 2, 2016 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board