United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

H.C., Appellant 

and 

DEPARTMENT OF VETERANS AFFAIRS, 

VETERANS ADMINISTRATION MEDICAL 

CENTER, Philadelphia, PA, Employer 

__________________________________________ 

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Docket No. 16-0145 

Issued: March 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 

COLLEEN DUFFY KIKO, Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On November 2, 2015 appellant filed a timely appeal of an October 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)(1) and 501.3, the Board has 

jurisdiction to consider the merits of the case. 

ISSUE 

The issue is whether appellant has met her burden of proof to establish that she was 

totally disabled from April 7 through 21, 2015 due to her accepted employment injury. 

FACTUAL HISTORY 

On July 8, 2012 appellant, then a 47-year-old food service worker leader, filed an 

occupational disease claim (Form CA-2) alleging that she was working a temporary assignment 

 1

 5 U.S.C. § 8101 et seq.
2

in social work services when on June 12, 2014 she was sexually harassed by a veteran. The 

veteran turned sideways to show he had an erection. The police came and removed him. The 

veteran returned 30 minutes later and approached her for help. Appellant alleged that she 

developed post-traumatic stress disorder (PTSD), depression, anxiety, and panic attacks. 

 In a letter dated July 16, 2014, OWCP informed appellant that her claim was more 

accurately one for a traumatic injury. It requested additional factual and medical information in 

support of her traumatic injury claim and allowed 30 days for a response. Appellant submitted a 

July 28, 2014 note from a nurse practitioner diagnosing PTSD. 

 Appellant also submitted a detailed narrative statement dated July 22, 2014 describing the 

events of June 12, 2014 in her temporary-detailed assignment at the reception desk. After 

recounting the incident in detail, she alleged that she was distraught and unable to leave her 

office while the veteran paced and yelled. About 30 minutes after the police removed him, the 

veteran returned to her office and asked if she could get him help. Appellant directed the veteran 

to sit in the waiting room and telephoned for help. The veteran eventually took a seat. Appellant 

sought further assistance and the assistant chief of social work came to her office and called the 

police to retrieve him again. She was later instructed that there was a red panic button under her 

desk to use in such situations. Appellant became further upset due to the lack of training she had 

received for this assignment. The next morning she was unable to get out of bed due to anxiety 

and panic attacks. Appellant’s anxiety continued and she sought medical treatment on June 23, 

2014 at a mental hospital. She reported that, after receiving medication, she was able to 

understand that her symptoms were due to PTSD resulting from prior, personal trauma as she 

had not had anxiety or panic attacks for 28 years. Appellant alleged that the incident with the 

veteran triggered things from her past trauma. She also noted that relating this information 

caused her anxiety and panic again. 

 By decision dated August 19, 2014, OWCP denied appellant’s claim finding that she had 

failed to submit the necessary medical evidence to establish her claim. 

 Appellant requested reconsideration on October 17, 2014 and submitted additional 

medical evidence. In a report dated October 10, 2014, Dr. Mary Ann Venezia, a psychiatrist, 

diagnosed anxiety secondary to PTSD. She described the employment incident and opined that 

appellant developed anxiety as a result of the incident. Dr. Venezia opined that appellant was 

currently totally disabled. 

 In a decision dated January 22, 2015, OWCP accepted appellant’s claim for a single 

episode of PTSD. Dr. William Greenfield, a psychiatrist, released appellant to return to work on 

January 12, 2015. OWCP authorized compensation benefits from October 10, 2014 through 

January 10, 2015 following appellant’s 45 days of continuation of pay. 

 Dr. Greenfield completed a report on April 22, 2015 and described appellant’s June 12, 

2014 employment incident. He noted that appellant was released to return to work on a trial 

basis on January 12, 2015. Dr. Greenfield opined that during the trial period appellant 

experienced an increase in symptoms causing her to be unable to consistently attend her 

scheduled work hours. He concluded that appellant was unable to work due to her accepted 

condition. 
3

 Appellant filed a recurrence claim (Form CA-2a) on April 24, 2015 alleging that on 

April 7, 2015 she stopped work due to a recurrence of her PTSD. She noted that she had been 

restricted to have no direct contact with patients. Appellant alleged that after her return to work 

she gradually found herself worsening and eventually unable to function due to PTSD and severe 

depression. 

 On May 11, 2015 Dr. Greenfield noted appellant’s June 12, 2014 employment injury and 

resulting depression and anxiety. He opined that since returning to work appellant experienced 

an increase in symptoms resulting in a return to an outpatient program. Dr. Greenfield 

concluded that appellant was currently unable to work and that he could not predict when she 

could return to work. He completed a letter dated June 5, 2015 and opined that appellant 

continued to experience anxiety due to PTSD as a result of the June 12, 2014 work injury. 

Dr. Greenfield found that she continued to experience daily intrusive memories and repetitive 

nightmares. He noted that appellant returned to work on a trial basis on January 12, 2015, but 

that her symptoms increased with her return to work and on April 7, 2015 her anxiety due to 

PTSD became unbearable and she left work and resumed treatment. Dr. Greenfield 

recommended on April 16, 2015 that appellant attends outpatient therapy three times a week, as 

well as weekly individual therapy and monthly medication management. He opined that 

appellant could not return to work due to her ongoing symptoms. 

 In a decision dated June 11, 2015, OWCP accepted appellant’s claim for recurrence of 

disability effective April 7, 2015 based on Dr. Greenfield’s June 5, 2015 report. 

 Appellant filed a Form CA-7 requesting compensation for leave without pay from April 7 

through June 19, 2015. OWCP authorized compensation benefits from April 22 through 

June 19, 2015. 

 In a letter dated June 1, 2015, OWCP requested medical evidence supporting appellant’s 

total disability for work from April 7 through 21, 2015. Appellant submitted form reports 

completed by Steven Weiss, a psychiatric nurse practitioner, on July 13, August 10, and 

October 9, 2015. On July 30, 2015 Ami Kent, a licensed clinical social worker, opined that 

Dr. Greenfield’s June 5, 2015 letter established appellant’s disability from April 7 

through 21, 2015. 

 Appellant filed an additional Form CA-7 requesting compensation for leave without pay 

from July 20 through August 14, 2015. She submitted treatment notes dated March 11, 26, and 

April 13 and 16, 2015 from Ms. Kent and Mr. Weiss. 

 OWCP authorized compensation benefits from July 18 through August 14, 2015 on 

August 19, 2015. Appellant continued to claim compensation benefits for leave without pay 

from August 17 through October 16, 2015 which OWCP authorized. 

 By decision dated October 21, 2015, OWCP denied appellant’s claim for compensation 

for the period April 7 through 21, 2015 finding that there was insufficient medical evidence to 

support her total disability for this period. 
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LEGAL PRECEDENT 

An employee seeking benefits under FECA2 has the burden of establishing the essential 

elements of his or her claim, including that any disability or specific condition for which 

compensation is claimed is causally related to the employment injury.3 The term disability is 

defined as the incapacity because of an employment injury to earn the wages the employee was 

receiving at the time of the injury, i.e., a physical impairment resulting in loss of wage-earning 

capacity.4

Whether a particular injury causes an employee to be disabled for employment and the 

duration of that disability are medical issues which must be proved by a preponderance of the 

reliable, probative, and substantial medical evidence.5

 Findings on examination are generally 

needed to support a physician’s opinion that an employee is disabled for work. When a 

physician’s statement regarding an employee’s ability to work consist only of repetition of the 

employee’s complaints that she hurt too much to work, without objective findings of disability 

being shown, the physician has not presented a medical opinion on the issue of disability or a 

basis for payment of compensation.6

 The Board will not require OWCP to pay compensation for 

disability in the absence of any medical evidence directly addressing the specific dates of 

disability for which compensation is claimed. To do so would essentially allow employees to 

self-certify their disability and entitlement to compensation.7 

Causal relationship is a medical issue and the medical evidence required to establish 

causal relationship is rationalized medical evidence.8 Rationalized medical evidence is medical 

evidence which includes a physician’s detailed medical opinion on the issue of whether there is a 

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

factors. 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.9 Neither the fact that a disease or 

condition manifests itself during a period of employment nor the belief that the disease or 

 2 Supra note 1. 

3 G.T., 59 ECAB 447 (2008); Kathryn Haggerty, 45 ECAB 383 (1994); Elaine Pendleton, 40 ECAB 1143 (1989). 

4

 20 C.F.R. § 10.5(f); see, e.g., Cheryl L. Decavitch, 50 ECAB 397 (1999) (where appellant had an injury but no 

loss of wage-earning capacity). 

5 See Fereidoon Kharabi, 52 ECAB 291 (2001). 

6 Id.

7 Id. 

8 Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000). 

9 Leslie C. Moore, 52 ECAB 132 (2000). 
5

condition was caused or aggravated by employment factors or incidents is sufficient to establish 

causal relationship.10

Certain healthcare providers such as physician assistants, nurse practitioners, physical 

therapists, and social workers are not considered physicians as defined under FECA.11 

Consequently, their medical findings and/or opinions will not suffice for purposes of establishing 

entitlement to FECA benefits.12

ANALYSIS 

The Board finds that appellant has not met her burden of proof to establish total disability 

from April 7 through 15, 2015 due to her accepted employment injury. The Board finds, 

however, that appellant has established total disability commencing on April 16, 2015 and is 

entitled to additional compensation from April 16 through 21, 2015. 

Appellant filed a Form CA-2a on April 24, 2015 alleging that on April 7, 2015 she 

stopped work due to a recurrence of her PTSD. She alleged that after her return to work she 

gradually found herself worsening and eventually unable to function due to PTSD and severe 

depression. In support of this claim, appellant submitted reports from Dr. Greenfield. 

Following, appellant’s alleged recurrence Dr. Greenfield completed a report dated 

April 22, 2015 providing her history of injury. He noted appellant’s return to work on a trial 

basis on January 12, 2015 and opined that during the trial period appellant experienced an 

increase in symptoms causing her to be unable to consistently attend her scheduled work hours. 

Dr. Greenfield concluded that appellant was unable to work due to her accepted condition. In his 

May 11, 2015 report, he again noted appellant’s history of injury and ongoing symptoms. 

Dr. Greenfield concluded that appellant was currently unable to work and that he could not 

predict when she could return to work. These reports are not sufficiently detailed to establish a 

specific period of disability due to appellant’s accepted recurrence of disability. Dr. Greenfield 

did not explain exactly when and why appellant stopped work and did not explain how her 

accepted condition rendered her totally disabled. 

On June 5, 2015 Dr. Greenfield opined that appellant continued to experience anxiety due 

to PTSD as a result of the June 12, 2014 employment injury. He found that she continued to 

experience daily intrusive memories and repetitive nightmares. Dr. Greenfield noted that 

appellant returned to work on a trial basis on January 12, 2015, but that her symptoms increased 

with her return to work and on April 7, 2015 her anxiety due to PTSD became unbearable and 

she left work and resumed treatment. Dr. Greenfield recommended on April 16, 2015 that 

appellant attend outpatient therapy three times a week, as well as weekly individual therapy and 

monthly medication management. He opined that appellant could not return to work due to her 

ongoing symptoms. The Board finds that this report is sufficient to establish appellant’s 

 10 Dennis M. Mascarenas, 49 ECAB 215 (1997). 

11 5 U.S.C. § 8101(2); 20 C.F.R. § 10.5(t). 

12 K.W., 59 ECAB 271, 279 (2007); David P. Sawchuk, 57 ECAB 316, 320 n.11 (2006). 
6

disability for work commencing April 16, 2015. Dr. Greenfield recommended additional 

treatment on that date, and provided reasoning for his conclusions for recurrence of appellant’s 

total disability, including symptoms of daily intrusive memories and repetitive nightmares. 

Dr. Greenfield did not, however, provide any specific details regarding appellant’s disability for 

work from April 7, 2015 when appellant stopped work until April 15, 2015. 

Appellant also submitted a series of reports from Mr. Weiss, a psychiatric nurse 

practitioner, and Ms. Kent, a licensed clinical social worker. As neither a nurse practitioner13 nor 

a social worker14 are considered physicians for the purposes of FECA. Reports from these 

practitioners thus do not constitute medical evidence, and their findings and opinions do not 

suffice for purposes of establishing entitlement to FECA benefits. 

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 total disability 

for the period April 7 through 15, 2015. The Board further finds that appellant has met her 

burden of proof to establish total disability commencing April 16, 2015 and that she is entitled to 

wage-loss compensation through April 21, 2015. 

 13 Supra note 11; a nurse practitioner is not a “physician” pursuant to FECA. Section 8101(2) of FECA provides 

as follows: “(2) ‘physician’ includes surgeons, podiatrists, dentists, clinical psychologists, optometrists, 

chiropractors, and osteopathic practitioners within the scope of their practice as defined by State law. Paul Foster, 

56 ECAB 208 (2004). 

14 P.H., Docket No. 15-0482 (issued August 4, 2015). 
7

ORDER 

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

Workers’ Compensation Programs is affirmed, as modified. 

Issued: March 2, 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