United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

C.C., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

St. Louis, MO, Employer

__________________________________________

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Docket No. 18-1099

Issued: December 21, 2018

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

CHRISTOPHER J. GODFREY, Chief Judge

ALEC J. KOROMILAS, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On May 7, 2018 appellant filed a timely appeal from a May 3, 2018 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 has met her burden of proof to establish that her lumbar 

condition was causally related the accepted January 29, 2018 employment incident.

FACTUAL HISTORY

On February 28, 2018 appellant, then a 45-year-old letter carrier, filed a traumatic injury 

claim (Form CA-1) alleging that on January 29, 2018 she injured her lower back when she lifted 

trays of mail while in the performance of her employment duties. She stopped work on 

 

1 5 U.S.C. § 8101 et seq. 
2

February 28, 2018. C.P., an employing establishment supervisor, controverted the claim as 

appellant had worked without apparent difficulty from January 29, 2018 until she reported the 

injury.

2

In support of her claim, appellant submitted a duty status report (Form CA-17) and urgent 

care center report dated February 28, 2018, both signed by a physician assistant.

By development letter dated March 28, 2018, OWCP advised appellant of the type of 

medical and factual evidence needed to establish her claim, including a detailed description of the 

February 28, 2018 employment incident, and a narrative report from her physician explaining how 

and why that event would cause the claimed back condition. It notified her that physician assistants 

were not considered physicians under FECA. OWCP afforded appellant 30 days to submit the 

necessary evidence. 

Appellant provided statements in which she described the sudden onset of left-sided low 

back pain with radiation into the left buttock when she lifted three trays of mail while at work on

January 29, 2018. She noted that she had delayed filing her claim as she hoped that her symptoms 

would abate without treatment. As over-the-counter medications were ineffective in reducing her 

pain symptoms, appellant sought treatment at an urgent care clinic on February 9, 2018.3

In a February 9, 2018 discharge note from an emergency department, Dr. Justin A. Rapoff, 

an osteopathic physician, related appellant’s diagnosis as left-sided low back pain with left-sided 

sciatica.

OWCP also received an urgent care report dated February 9, 2018 signed by Daniel 

Zwilling, a physician assistant, with discharge instructions.

In a report dated February 12, 2018, Dr. Faquir Muhammud, an attending Board-certified 

internist, held appellant off work from February 9 to 18, 2018. He returned appellant to work 

effective February 19, 2018.

In a report dated March 1, 2018, Dr. Chris Beuer, an attending physician Board-certified 

in anesthesiology and pain management, noted treating appellant from February 19 to 

March 4, 2018. He restricted appellant from “heavy lifting, repetitive bending, twisting, or 

walking due to lumbar disc injury for 30 days.”

Appellant also provided an urgent care report dated March 14, 2018 signed by Andrew 

Wahle, a physician assistant; a March 28, 2018 report signed by Tiffany Meinert, a physician 

assistant; and an April 10, 2018 report by Philip Dudak, a nurse practitioner. 

By decision dated May 3, 2018, OWCP denied appellant’s traumatic injury claim. It found 

that the incident occurred as alleged, but denied the claim as the medical evidence of record was 

 

2

In a letter dated March 26, 2016, D.B., an employment establishment official, contended that appellant may not 

have injured herself at work.

3 Appellant also submitted a witness statement dated April 4, 2018 from D.T., a coworker, who asserted that he 

witnessed appellant informing a supervisor of her injury on January 29, 2018.
3

insufficient to establish that the diagnosed medical condition was causally related to the accepted 

January 29, 2018 employment incident.

LEGAL PRECEDENT

An employee seeking benefits under FECA4 has the burden of proof to establish 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 is causally related to the 

employment injury.5 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.6

To determine whether an employee sustained a traumatic injury in the performance of duty, 

OWCP must determine whether fact of injury has been established. First, an employee has the 

burden of proof to demonstrate the occurrence of an injury at the time, place, and in the manner 

alleged, by a preponderance of the reliable, probative, and substantial evidence.7 Second, the 

employee must submit medical evidence to establish that the employment incident caused a 

personal injury. 

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

relationship is rationalized medical evidence.8 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 employee.9 

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 causal relationship.10

ANALYSIS

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

condition was causally related to the accepted January 29, 2018 employment incident.

 

4 Supra note 2.

5 Alvin V. Gadd, 57 ECAB 172 (2005); Anthony P. Silva, 55 ECAB 179 (2003). 

6 See Elizabeth H. Kramm (Leonard O. Kramm), 57 ECAB 117 (2005); Ellen L. Noble, 55 ECAB 530 (2004).

7 David Apgar, 57 ECAB 137 (2005); Delphyne L. Glover, 51 ECAB 146 (1999). 

8 G.N., Docket No. 18-0403 (issued September 13, 2018); Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000).

9 Leslie C. Moore, 52 ECAB 132 (2000); Gary L. Fowler, 45 ECAB 365 (1994).

10 Dennis M. Mascarenas, 49 ECAB 215 (1997).
4

Appellant was initially seen by Dr. Rapoff on February 9, 2018 who diagnosed left-sided 

sciatica; however, he offered no history of injury or opinion regarding the cause of this condition. 

The Board has held that medical evidence that does not offer an opinion regarding the cause of an 

employee’s condition is of no probative value regarding the issue of causal relationship.11

Dr. Muhammud provided a work absence slip dated February 12, 2018 holding appellant 

off from work from February 9 to 18, 2018 for an unspecified condition. He did not address causal 

relationship. To establish personal injury the medical evidence of record must document a 

diagnosed condition and must explain how that condition is causally related to the accepted 

employment incident. Lacking a firm diagnosis and rationalized medical opinion regarding causal 

relationship, Dr. Muhammud’s report is of limited probative value.12 

In a report dated March 1, 2018, Dr. Beuer diagnosed a lumbar disc injury and provided 

work restrictions. He did not, however, provide a firm diagnosis and a rationalized medical 

opinion, based upon a history of injury, explaining how the diagnosed condition was caused by 

the accepted January 29, 2018 employment incident. Dr. Beuer’s report was therefore of limited 

probative value.13

Appellant also submitted reports from Mr. Zwilling, Mr. Wahle, and Ms. Meinert, 

physician assistants, and Mr. Dudak, a nurse practitioner. The Board has held that medical reports 

signed solely by a physician assistant or nurse practitioner are of no probative value as a physician 

assistant or nurse practitioner is not considered a physician as defined under FECA and therefore 

is not competent to provide a medical opinion.14

In a letter dated March 28, 2018, OWCP requested that appellant submit a comprehensive 

report from her treating physician which included a reasoned explanation as to how the accepted 

work incident had caused her claimed injury. An award of compensation may not be based on 

surmise, conjecture, speculation, or on the employee’s own belief of causal relation.15 Appellant’s 

honest belief that the accepted January 29, 2018 employment incident caused an injury, however 

sincerely held, does not constitute medical evidence sufficient to establish causal relationship.16

 

11 See L.B., Docket No. 18-0533 (issued August 27, 2018); D.K., Docket No. 17-1549 (issued July 6, 2018).

12 See D.S., Docket No. 18-0061 (issued May 29, 2018). 

13 See R.K., Docket No. 17-0599 (issued June 23, 2017).

14 See David P. Sawchuk, 57 ECAB 316, 320 n.11 (2006) (lay individuals such as physician assistants, nurses and 

physical therapists are not competent to render a medical opinion under FECA); 5 U.S.C. § 8101(2) (this subsection 

defines a physician as surgeons, podiatrists, dentists, clinical psychologists, optometrists, chiropractors, and 

osteopathic practitioners within the scope of their practice as defined by state law). E.T., Docket No. 17-0265 (issued 

May 25, 2018) (physician assistants are not considered physicians under FECA). S.J., Docket No. 17-0783, n.2 (issued 

April 9, 2018) (nurse practitioners are not considered physicians under FECA).

15 G.N., supra note 8; D.D., 57 ECAB 734 (2006).

16 G.N., supra note 8. See J.S., Docket No. 17-0967 (issued August 23, 2017).
5

Because appellant has not submitted reasoned medical evidence explaining how the

diagnosed medical condition was caused by the accepted January 29, 2018 employment incident, 

she has not met her burden of proof.17

On appeal, appellant asserts that the medical evidence of record is sufficient to meet her 

burden of proof to establish causal relationship. As noted above, OWCP properly denied 

appellant’s traumatic injury claim as her physicians’ reports contained insufficient medical 

reasoning to establish that the accepted employment incident caused the claimed injury.

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 that her lumbar 

condition was causally related the accepted January 29, 2018 employment incident.

ORDER

IT IS HEREBY ORDERED THAT the May 3, 2018 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: December 21, 2018

Washington, DC

Christopher J. Godfrey, 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

 

17 G.N., supra note 8, Y.J., Docket No. 08-1167 (issued October 7, 2008); A.D., 58 ECAB 149 (2006); D’Wayne 

Avila, 57 ECAB 642 (2006).