United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

J.F., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Salt Lake City, UT, Employer

__________________________________________

)

)

)

)

)

)

)

)

Docket No. 16-1204

Issued: November 13, 2017

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 May 18, 2016 appellant filed a timely appeal of an April 25, 2016 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 to 

consider the merits of this case.

ISSUE

The issue is whether appellant met her burden of proof to establish an injury causally 

related to the accepted March 2, 2016 employment incident.

FACTUAL HISTORY

On March 8, 2016 appellant, then a 39-year-old carrier, filed a traumatic injury claim 

(Form CA-1) alleging that she sustained a back strain on March 2, 2016 while removing a 

package that was blocking a mailbox. She stopped work on the date of injury.

 

1

5 U.S.C. § 8101 et seq.
2

In support of her claim, appellant submitted a March 8, 2016 report on the Forthill 

Family Clinic, which was prepared and electronically signed by Sabrina Steele, a physician 

assistant. At the end of the report it was noted that Dr. Jose Azarcon, Jr., an osteopathic 

physician Board-certified in family medicine, an affiliated physician with the Forthill Family 

Clinic, had reviewed and approved the visit details and generated the report.

2

 Under assessment,

Ms. Steele noted a lower back injury was sustained at work with a recommendation that 

appellant be off work for the period March 2 to 22, 2016. A diagnosis of back pain due to work 

trauma on March 2, 2015 was noted under history of illness. Physical examination findings and 

injury history were provided.

In a letter dated March 21, 2016, OWCP informed appellant that the evidence of record 

was insufficient to establish her claim. It noted that the only medical evidence received had been 

from a physician assistant. OWCP advised appellant that physician assistants are not considered 

physicians under FECA. It informed her of the medical and factual evidence required to support 

her claim and afforded her 30 days to provide the requested information.

In response to OWCP’s letter, appellant submitted medical evidence dated March 8 

and 15, 2016.

A March 8, 2016 duty status report (Form CA-17), bearing Ms. Steele’s signature 

diagnosed a lower back injury. The injury was described as occurring on March 2, 2016 when 

appellant strained her lower/middle back while removing a stuck package from a mail collection 

box. Appellant was advised to be off work until March 23, 2016.

Ms. Steele completed a March 15, 2016 attending physician’s report (Form CA-20) 

noting a diagnosis of lower back injury and a return to work date of March 22, 2016. The injury 

was described as occurring on March 2, 2016 when appellant felt back pain while trying to 

unjam a package out of a mail collection box. Physical findings included muscle spasms.

By decision dated April 25, 2016, OWCP found the incident occurred as alleged, but

denied the claim as she failed to submit any medical evidence containing a diagnosis causally 

related to the accepted employment incident. It also found the only medical evidence appellant 

submitted was from a physician assistant who is not considered a physician under FECA.

LEGAL PRECEDENT

An employee seeking benefits under FECA3has 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 and/or specific condition for which compensation is claimed are causally related to the 

 

2 There is no indication that the report was cosigned by Dr. Azarcon.

3

5 U.S.C. § 8101 et seq.
3

employment injury.4 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.5

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.6 

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.7 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.8

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

establish causal relationship is rationalized medical opinion evidence.9 Rationalized medical 

opinion evidence is medical evidence which includes a physician’s rationalized opinion on 

whether there is causal relationship between the employee’s diagnosed condition and the 

compensable employment factors.10 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.11

Medical opinion, in general, can only be given by a qualified physician.12 Section 

8101(2) of FECA provides that “physician” includes surgeons, podiatrists, dentists, clinical 

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

practice as defined by State law.13 Registered nurses, licensed practical nurses, and physician

assistants are not “physicians” as defined under FECA. Their opinions are of no probative 

value.14 

 

4 C.S., Docket No. 08-1585 (issued March 3, 2009); Bonnie A. Contreras, 57 ECAB 364 (2006).

5

S.P., 59 ECAB 184 (2007); Joe D. Cameron, 41 ECAB 153 (1989).

6 B.F., Docket No. 09-60 (issued March 17, 2009); Bonnie A. Contreras, supra note 4.

7 D.B., 58 ECAB 464 (2007); David Apgar, 57 ECAB 137 (2005).

8 C.B., Docket No. 08-1583 (issued December 9, 2008); D.G., 59 ECAB 734 (2008); Bonnie A. Contreras, supra

note 4.

9

Y.J., Docket No. 08-1167 (issued October 7, 2008); A.D., 58 ECAB 149 (2006); D’Wayne Avila, 57 ECAB 

642 (2006).

10 J.J., Docket No. 09-27 (issued February 10, 2009); Michael S. Mina, 57 ECAB 379 (2006).

11 I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 ECAB 345, 352 (1989).

12 E.K., Docket No. 09-1827 (issued April 20, 2010); Allen C. Hundley, 53 ECAB 551 (2002).

13 5 U.S.C. § 8101(2); see Roy L. Humphrey, 57 ECAB 238 (2005).

14 Roy L. Humphrey, id.
4

ANALYSIS

It is undisputed that the March 2, 2016 work incident occurred as alleged. In support of 

her claim, appellant submitted a March 8, 2016 report signed by Ms. Steele, a physician 

assistant, and reviewed, approved, and generated by Dr. Azarcon, an osteopathic physician 

Board-certified in family medicine. The report diagnosed a lower back injury due to the 

accepted March 2, 2016 employment incident.

OWCP denied the claim, by decision dated April 25, 2016, finding that causal 

relationship was not established due to a lack of medical evidence. It found that the March 8, 

2016 report was of no probative value as it was signed only by a physician assistant and not 

countersigned by a physician. OWCP was correct in noting that a physician assistant is not 

considered a physician under FECA and her opinion is of no probative value.15 However, 

reports that are reviewed and countersigned by a physician do constitute probative medical 

evidence.16 The March 8, 2016 report of Ms. Steele indicates that it was reviewed, approved,

and generated by Dr. Azarcon, a physician at the Forthill Clinic. While this report was not 

signed by Dr. Azarcon, the report states:

“Encounter submitted for review by Sabrina L. Steele, [physician assistant], on 

[March 8, 2016], 7:30 [p.m.]. Visit details reviewed and approved by supervising 

provider, Jose Azarcon, Jr., DO on [March 8, 2016].

“Electronically signed by: Sabrina Steele, [physician assistant] [March 8, 2016]

Document generated by: Jose Azarcon, Jr., [March 8, 2016] 09:46 [p.m.].”

The Board, therefore, finds that there are sufficient indicia of identification reflecting 

review and approval of the report by the supervising physician.17 Therefore, the Board finds that 

the report is competent medical evidence. 

The case will be remanded to OWCP for a review of the March 8, 2016 report from

Dr. Azarcon. Following this and any further development of the medical evidence deemed 

necessary, OWCP shall issue a de novo merit decision in the case.

CONCLUSION

The Board finds that the case is not in posture for a decision. 

 

15 5 U.S.C. § 8101(2); E.K., supra note 12; J.M., 58 ECAB 303 (2007); David P. Sawchuk, 57 ECAB 316, 320 

n.11 (2006).

16 Thomas L. Agee, 56 ECAB 465 (2005); Richard F. Williams, 55 ECAB 343 (2004); Merton J. Sills, 39 ECAB 

572 (1988).

17 See Y.S., Docket No. 16-0882 (issued August 19, 2016). While the medical reports may be unsigned, if there is 

sufficient indicia of identification concerning its author and authorship that can be ascertained, the reports are of 

probative value.
5

ORDER

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

Compensation Programs dated April 25, 2016 is set aside and the case is remanded for further 

proceedings consistent with the above opinion.

Issued: November 13, 2017

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