United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

V.C., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Beaver Dam, WI, Employer 

__________________________________________ 

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Docket No. 16-0642 

Issued: April 19, 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 February 17, 2016 appellant filed a timely appeal from a November 24, 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 has established an injury causally related to a 

January 27, 2015 employment incident. 

 1

 5 U.S.C. § 8101 et seq. 

2

 The Board notes that appellant submitted additional evidence on appeal after OWCP rendered its November 24, 

2015 decision. The Board’s jurisdiction is limited to reviewing the evidence that was before OWCP at the time of 

its final decision. Therefore, the Board lacks jurisdiction to review this additional evidence. 20 C.F.R. 

§ 501.2(c)(1). 
2

FACTUAL HISTORY 

On January 27, 2015 appellant, then a 50-year-old mail carrier, filed a traumatic injury 

claim (Form CA-1) alleging that on that date she fell on ice while in the performance of duty. 

She indicated that she fell on her right elbow and arm. The reverse of the claim form indicated 

that appellant stopped working on January 27, 2015. 

The record indicates that appellant received treatment from a nurse and nurse practitioner 

at a hospital on January 27, 2015. Appellant provided a history of a fall, landing on flexed 

elbow, and jamming the shoulder. The hospital report contains x-ray results from Dr. Orlin 

Hadjiev, a Board-certified radiologist, who reported that there was no evidence of a fracture of 

the right elbow, and no evidence of fracture or misalignment of the right shoulder. The record 

also contains reports from a nurse practitioner dated February 2, 10, and 23, 2015. 

By letter dated March 18, 2015, OWCP requested that appellant submit additional 

medical evidence to support her claim. Appellant was afforded 30 days in which to respond. 

Appellant submitted a May 9, 2015 magnetic resonance imaging (MRI) scan report for 

the right shoulder from Dr. Deidre Rippi, a radiologist, who reported a full-thickness tear of the 

anterior half fibers of the supraspinatus, superimposed on tendinopathy. She was also seen by a 

physician assistant on March 4 and 13, 2015. 

By decision dated May 20, 2015, OWCP denied the claim for compensation. It found the 

medical evidence was insufficient to establish an injury causally related to a January 27, 2015 

employment incident. 

Appellant requested a review of the written record by an OWCP hearing representative 

on June 10, 2015. She submitted a July 2, 2015 report that was prepared by Dr. Bert Callahan, a 

Board-certified orthopedic surgeon, on July 17, 2015. Dr. Callahan indicated that appellant was 

seen for a preoperative consult, and reported a history that appellant fell on ice while delivering 

mail on January 27, 2015. The report provided results on examination and noted results of the 

May 9, 2015 MRI scan. Dr. Callahan indicated that appellant had right shoulder pain and was 

working light duty. 

By decision dated November 24, 2015, the OWCP hearing representative affirmed the 

May 20, 2015 decision. She found the medical evidence was insufficient to establish the claim 

for compensation. 
3

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 filed within the applicable time 

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

disability 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 actually sustained an injury in the performance of 

duty, OWCP begins with an analysis of whether fact of injury has been established. Generally, 

fact of injury consists of two components which must be considered in conjunction with one 

another. The first component to be established is that the employee actually experienced the 

employment incident which is alleged to have occurred.5

 The second component is whether the 

employment incident caused a personal injury and generally can be established only by medical 

evidence. 

 To establish a causal relationship between the condition, as well as any attendant 

disability claimed and the employment event or incident, the employee must submit rationalized 

medical opinion evidence supporting such a causal relationship.6

 The opinion of the physician 

must be based on a complete factual and medical background of the claimant, 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 claimant. This medical opinion must include an accurate history of the 

employee’s employment injury and must explain how the condition is related to the injury. The 

weight of 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.7

ANALYSIS 

In the present case, appellant has claimed an injury resulting from a fall at work on 

January 27, 2015. OWCP has accepted that an incident occurred, but found that the medical 

evidence was insufficient to establish the claim. With respect to the medical evidence, the Board 

notes that to be of probative value a medical report must be from a physician under FECA. 5 

U.S.C. § 8101(2) provides that a physician includes, “surgeons, podiatrists, dentists, clinical 

psychologists, optometrists, chiropractors, and osteopathic practitioners within the scope of their 

 3 Gary J. Watling, 52 ECAB 278 (2001); Elaine Pendleton, 40 ECAB 1143, 1154 (1989). 

4 Michael E. Smith, 50 ECAB 313 (1999). 

5 Elaine Pendleton, supra note 3. 

6 See 20 C.F.R. § 10.110(a); John M. Tornello, 35 ECAB 234 (1983). 

7 James Mack, 43 ECAB 321 (1991). 
4

practice as defined by state law.”8 As to medical evidence from a physician assistant or nurse 

practitioner, this does not constitute competent medical evidence under FECA.9

 Therefore the 

medical reports in the record from the nurse practitioner and physician assistant are of no 

probative value in establishing the claim. 

Dr. Rippi, the radiologist, described a right shoulder rotator cuff tear, but did not discuss 

causal relationship with a January 27, 2015 employment incident. Dr. Callahan provided a brief 

history of the January 27, 2015 employment incident in the July 2, 2015 report, without 

providing additional relevant detail. He does not provide a medical opinion as to causal 

relationship between a diagnosed condition and the January 27, 2015 employment incident. 

Therefore the Board finds the report is not sufficient to establish an injury in the performance of 

duty on January 27, 2015. 

It is appellant’s burden of proof to establish her claim. The medical evidence of record is 

insufficient to meet her burden of proof in this case. 

On appeal, appellant asserts that she had no choice but to be seen by a nurse practitioner 

or a physician assistant. Her treatment by a nonphysician does not preclude her from submitting 

probative medical evidence from a physician on the issues presented. Appellant did submit 

additional medical evidence on appeal, but as noted above, the Board can consider only evidence 

that was before OWCP as of the issuance of the November 24, 2015 decision.10 She 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 an injury 

causally related to a January 27, 2015 employment incident. 

 8

 5 U.S.C. § 8101(2). 

9 See C.J., Docket No. 15-1697 (issued February 5, 2016); Irma J. Flood, Docket No. 05-1522 (issued 

April 17, 2006). 

10 See supra note 2. 
5

ORDER 

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

Compensation Programs dated November 24, 2015 is affirmed. 

Issued: April 19, 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