United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

J.S., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Salt Lake City, UT, Employer 

__________________________________________ 

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Docket No. 16-0184 

Issued: March 2, 2016 

Appearances: Case Submitted on the Record

Appellant, pro se 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

ALEC J. KOROMILAS, Alternate Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On November 10, 2015 appellant filed a timely appeal from a September 23, 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 his burden of proof to establish right hand conditions 

causally related to a July 27, 2015 employment incident. 

FACTUAL HISTORY 

On July 29, 2015 appellant, a 55-year-old clerk, filed a traumatic injury claim (Form 

CA-1) alleging that he sustained an injury to his right little finger on July 27, 2015 as a result of 

transferring trays of mail from one cage to another in the performance of duty. In a July 29, 

                                                             1

 5 U.S.C. § 8101 et seq. 
2 

2015 narrative statement, he explained that, while lifting letter trays from one cage to another, he 

took off his right glove to wipe his brow and while putting the glove back on he noticed that his 

right little finger felt numb. Appellant stated that he was not worried about it until he woke up 

on July 29, 2015 and noticed that he was unable to use that finger, which appeared numb and 

crooked. He did not stop work. 

An OWCP Form CA-16, authorization for examination, was issued by the employing 

establishment on July 29, 2015. Appellant was authorized to visit First Med in Murray, Utah. 

He submitted reports dated July 29, 2015 from Joshua Bailey, a physician assistant at First Med, 

who diagnosed finger paresthesia and released appellant to modified duty with the following 

restrictions: pushing or pulling up to five pounds, with a right arm limitation of two pounds. 

In a July 30, 2015 letter, the employing establishment controverted appellant’s claim on 

the basis that the evidence failed to establish causal relationship or fact of injury. 

In an August 6, 2015 letter, OWCP notified appellant of the deficiencies in his claim and 

afforded him 30 days to submit additional evidence and respond to its inquiries. 

Appellant submitted a narrative statement dated August 22, 2015 reiterating the factual 

history of his claim and reports dated July 29 and August 5, 2015 from Mr. Bailey. 

On August 6, 2015 Dr. Terry Brown, a Board-certified occupational medicine specialist, 

ordered an electromyography (EMG) study. 

In reports dated August 11 through September 2, 2015, Dr. Stephanie Plunkett, a Boardcertified family practitioner, diagnosed neuritis of upper extremity, paresthesias in right hand, 

and weakness and numbness of right hand fifth finger. She asserted that appellant was working 

in the mail room on July 27, 2015, took off his work gloves, and then lifted and placed several 

trays of mail. When appellant was done he put his gloves back on and noticed that his right fifth 

finger was numb and that it would not move correctly. Dr. Plunkett opined that appellant’s 

condition was causally related to the July 27, 2015 employment incident, noting that “the 

temporal relationship [was] too strong.” She indicated that appellant was awaiting an EMG 

study and released him to modified duty with the following restrictions: lifting no more than 5 to 

10 pounds with the right arm. 

In reports dated August 28, 2015, Susanne F. Jones, a certified nurse practitioner, 

diagnosed hand paresthesia and weakness of hand due to reaching to grab overhead letters at 

work on July 29, 2015. Ms. Jones released appellant to modified duty with a 10-pound right arm 

lifting restriction. 

By decision dated September 23, 2015, OWCP denied appellant’s claim, finding that the 

medical evidence was not sufficient to establish a causal relationship between his right hand 

conditions and the July 27, 2015 employment incident. 

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 
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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, 

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 he 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 

OWCP accepted that the employment incident of July 27, 2015 occurred at the time, 

place, and in the manner alleged. The issue is whether appellant’s right hand conditions resulted 

from the employment incident. The Board finds that appellant has not met his burden of proof to 

establish right hand conditions causally related to the July 27, 2015 employment incident. 

In her reports, Dr. Plunkett diagnosed neuritis of upper extremity, right hand paresthesias, 

and weakness and numbness of right hand fifth finger. She opined that appellant’s condition was 

causally related to the July 27, 2015 employment incident, noting that “the temporal relationship 

[was] too strong.” Dr. Plunkett noted that appellant was awaiting an EMG study and released 

him to modified duty with a 5- to 10-pound right arm lifting restriction. The Board finds that 

Dr. Plunkett failed to provide a rationalized opinion explaining how transferring trays of mail on 

July 27, 2015 caused or aggravated appellant’s right hand conditions. Dr. Plunkett noted that 

appellant’s conditions occurred while he was at work, but such generalized statements do not 

                                                             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 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). 
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establish causal relationship because they merely repeat appellant’s allegations and are 

unsupported by adequate medical rationale explaining how his physical activity at work actually 

caused or aggravated the diagnosed conditions.6

 She did not provide sufficient medical rationale 

explaining the mechanism of how appellant’s right hand conditions were caused or aggravated 

by lifting and placing trays of mail on July 27, 2015. Dr. Plunkett noted that her opinion was 

based, in part, on temporal correlation. However, the Board has held that neither the mere fact 

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

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

establish a causal relationship.7

 Dr. Plunkett did not otherwise sufficiently explain the reasons 

why diagnostic testing and examination findings led her to conclude that the July 27, 2015 

incident at work caused or contributed to the diagnosed conditions. Thus, the Board finds that 

the reports from Dr. Plunkett are insufficient to establish that appellant sustained an 

employment-related injury. 

Dr. Brown ordered an EMG study on August 6, 2015 but did not specifically address 

whether the July 27, 2015 work incident caused or contributed to a diagnosed condition. 

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

 Thus, the Board finds that 

appellant did not meet his burden of proof with this submission. 

Appellant also submitted evidence from a physician assistant and a nurse practitioner. 

These documents do not constitute competent medical evidence because neither nurse 

practitioners nor physician assistants are considered “physicians” as defined under FECA.9 As 

such, this evidence is also insufficient to meet appellant’s burden of proof. 

The Board also notes that the employing establishment issued appellant a Form CA-16 on 

July 29, 2015 authorizing medical treatment. The Board has held that where an employing 

establishment properly executes a Form CA-16, which authorizes medical treatment as a result of 

an employee’s claim for an employment-related injury, it creates a contractual obligation, which 

does not involve the employee directly, to pay the cost of the examination or treatment regardless 

of the action taken on the claim.10 Although OWCP denied appellant’s claim for an injury, it did 

not address whether he is entitled to reimbursement of medical expenses pursuant to the Form 

CA-16. 

                                                             6 See K.W., Docket No. 10-98 (issued September 10, 2010). 

7 E.J., Docket No. 09-1481 (issued February 19, 2010). 

8 Jaja K. Asaramo, 55 ECAB 200 (2004). 

9

 5 U.S.C. § 8101(2); Sean O’Connell, 56 ECAB 195 (2004) (reports by nurse practitioners and physician 

assistants are not considered medical evidence as these persons are not considered physicians under FECA). See 

also Gloria J. McPherson, 51 ECAB 441 (2000); Charley V.B. Harley, 2 ECAB 208, 211 (1949) (a medical issue 

such as causal relationship can only be resolved through the submission of probative medical evidence from a 

physician). 

10 See D.M., Docket No. 13-535 (issued June 6, 2013). See also 20 C.F.R. §§ 10.300, 10.304. 
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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 his burden of proof to establish right hand 

conditions causally related to a July 27, 2015 employment incident. 

ORDER 

IT IS HEREBY ORDERED THAT the September 23, 2015 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: March 2, 2016 

Washington, DC 

 

 Patricia H. Fitzgerald, Deputy 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