United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

J.M., Appellant

and

DEPARTMENT OF HEALTH & HUMAN 

SERVICES, NATIONAL INSTITUTES OF 

HEALTH, Bethesda, MD, Employer

__________________________________________

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Docket No. 19-0478

Issued: August 9, 2019

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

JANICE B. ASKIN, Judge

ALEC J. KOROMILAS, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On December 27, 2018 appellant filed a timely appeal from October 23, 2018 merit 

decisions 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

ISSUES

The issues are: (1) whether appellant has met her burden of proof to establish total

disability for the period July 7, 2018 and continuing causally related to her accepted May 1, 2018 

 

1 5 U.S.C. § 8101 et seq.

2 The Board notes that following the October 23, 2018 decisions, OWCP received additional evidence. However, 

the Board’s Rules of Procedure provides: “The Board’s review of a case is limited to the evidence in the case record 

that was before OWCP at the time of its final decision. Evidence not before OWCP will not be considered by the 

Board for the first time on appeal.” 20 C.F.R. § 501.2(c)(1). Thus, the Board is precluded from reviewing this 

additional evidence for the first time on appeal. Id.
2

employment injury; and (2) whether appellant has met her burden of proof to expand the

acceptance of her claim to include the conditions of spinal stenosis, spondylolisthesis, and 

sacroiliac joint osteoarthritis, as causally related to the accepted May 1, 2018 employment injury. 

FACTUAL HISTORY

On May 22, 2018 appellant, then a 57-year-old food service worker, filed a traumatic injury 

claim (Form CA-1) alleging that on May 1, 2018, she tripped over a rug and sustained knee and 

elbow injuries while in the performance of duty. She stopped work that day. On June 6, 2018 

OWCP accepted appellant’s claim for bilateral knee contusions.

On September 1, 2018 appellant submitted a claim for compensation (Form CA-7) for 

leave without pay (LWOP) due to total disability during the period July 7 to August 18, 2018. On 

September 10, 2018 she submitted a Form CA-7 for LWOP for intermittent disability during the 

period August 19 through September 1, 2018. 

In a letter dated September 14, 2018, OWCP requested that appellant’s treating physician,

Dr. Marc E. Rankin, a Board-certified orthopedic surgeon, provide an updated narrative medical 

report detailing appellant’s condition. 

In a report dated September 10, 2018, Dr. Rankin diagnosed spinal stenosis of lumbar 

region with neurogenic claudication, presence of left artificial knee joint, spondylolisthesis, and 

osteoarthritis of sacroiliac joint, based on a bone scan of appellant’s left knee and a magnetic 

resonance imaging (MRI) scan of appellant’s back. He indicated that she complained of severe 

pain in her left knee, which she related began after a fall at work. Dr. Rankin opined that appellant 

was to remain off of work.

In a development letter dated September 20, 2018, OWCP informed appellant that 

additional medical evidence was necessary to establish her claim for compensation, and requested 

that she submit medical evidence establishing total disability due to the accepted conditions for 

the periods of wage loss claimed. It afforded her 30 days to respond. 

In a separate letter of even date, OWCP advised appellant that it had received her 

physician’s notification of newly diagnosed conditions of spinal stenosis, spondylolisthesis, and 

sacroiliac joint osteoarthritis, allegedly causally related to her accepted May 1, 2018 employment 

injury. Appellant was advised that additional medical evidence was necessary to expand 

acceptance of her claim. OWCP afforded her 30 days to submit the necessary evidence. 

On September 20, 2018 appellant submitted a Form CA-7 for LWOP for intermittent 

disability for the period September 2 through 15, 2018. 

In a work capacity evaluation form (Form OWCP-5c) dated September 25, 2018, Cheree 

Jamison, a physician assistant, indicated that appellant was still experiencing bilateral knee and 

leg pain. She noted that appellant was totally disabled from work, and that she had yet to reach 

maximum medical improvement. 

On October 15, 2018 appellant submitted a Form CA-7 for LWOP for total disability for 

the period September 17 to October 7, 2018. 
3

By decision dated October 23, 2018, OWCP denied appellant’s claim for compensation for 

disability for the period beginning July 7, 2018 and continuing. 

By separate decision of even date, OWCP denied the expansion of the acceptance of 

appellant’s claim to include the additional conditions of spinal stenosis, spondylolisthesis, and 

sacroiliac joint osteoarthritis. 

LEGAL PRECEDENT -- ISSUE 1

An employee seeking benefits under FECA3 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.4

Under FECA 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.5

Whether a particular injury causes an employee disability for employment is a medical 

issue which must be resolved by competent medical evidence.6 Whether a particular injury causes 

an employee to be disabled from work and the duration of that disability, are medical issues that 

must be proven by a preponderance of the reliable, probative, and substantial medical evidence.7

For each period of disability claimed, the employee has the burden of proof to establish 

that she was disabled for work as a result of the accepted employment injury.8 The Board will not 

require OWCP to pay compensation for disability in the absence of medical evidence directly 

addressing the specific dates of disability for which compensation is claimed. To do so, would 

essentially allow an employee to self-certify their disability and entitlement to compensation.9

To establish causal relationship between the disability claimed and the employment injury, 

an employee must submit rationalized medical evidence, based on a complete factual and medical 

background, supporting such causal relationship.10 Causal relationship is a medical issue and the 

 

3 Supra note 1. 

4 S.J., Docket No. 17-0828 (issued December 20, 2017); G.T., Docket No. 07-1345 (issued April 11, 2008); Kathryn 

Haggerty, 45 ECAB 383 (1994); Elaine Pendleton, 40 ECAB 1143 (1989).

5 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).

6 T.G., Docket No. 18-1064 (issued April 26, 2019). 

7

Id. 

8 B.F., Docket No. 19-0123 (issued May 13, 2019); M.D., Docket No. 18-0474 (issued October 3, 2018); see 

Amelia S. Jefferson, 57 ECAB 183 (2005); see also Nathaniel Milton, 37 ECAB 712 (1986).

9

Id.

10 See S.J., supra note 4; Kathryn E. DeMarsh, 56 ECAB 677 (2005).
4

medical evidence required to establish causal relationship is rationalized medical evidence.11 The 

opinion of the physician must be one of reasonable medical certainty, and must be supported by 

medical rationale explaining the nature of the relationship.12

The Board will not require OWCP to pay compensation for disability in the absence of 

medical evidence directly addressing the specific dates of disability for which compensation is 

claimed. To do so would essentially allow an employee to self-certify his or her disability and 

entitlement to compensation.13

ANALYSIS -- ISSUE 1

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

for the period July 7, 2018 and continuing causally related to her accepted May 1, 2018 

employment injury.

In support of her claim, appellant submitted a medical report from Dr. Rankin. In his 

September 10, 2018 report, Dr. Rankin diagnosed several lumbar conditions and noted the 

presence of a left artificial knee joint. He indicated that appellant complained of severe pain in 

her left knee, which she related began after a fall at work, and also opined that appellant was to 

remain off of work. However, Dr. Rankin did not provide medical rationale which explained why 

objective findings of appellant’s accepted knee conditions caused her disability.14 Subjective 

complaints of pain are insufficient, in and of themselves, to support payment of compensation.15 

When physician’s statements regarding an employee’s ability to work consist only of recitation of 

the employee’s complaints that he or she was in too much pain to work, without objective findings 

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

disability.16 The Board finds that, without medical rationale supporting disability, Dr. Rankin’s 

reports are insufficient to meet appellant’s burden of proof.17 His reports, therefore, do not 

establish that appellant was disabled from work during the claimed period due to her accepted knee 

conditions.

 

11 Id.

12 See supra note 10.

13 V.B., Docket No. 18-1273 (issued March 4, 2019); see William A. Archer, 55 ECAB 674 (2004); see also 

Fereidoon Kharabi, 52 ECAB 291 (2001).

14 See D.V., Docket No. 17-1344 (issued March 19, 2018). 

15 B.F., supra note 8.

16 B.F., supra note 8; P.D., Docket No. 14-0744 (issued August 6, 2014); G.T., 59 ECAB 447 (2008).

17 S.H., Docket No. 18-1398 (issued March 12, 2019).
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Appellant also submitted a Form OWCP-5c from Ms. Jamison, a physician assistant. 

However, physician assistants are not considered physicians under FECA and their opinions 

regarding disability therefore do not constitute probative medical evidence.18

As the medical evidence of record is insufficient to establish that appellant was disabled 

from work for the period July 7, 2018 and continuing due to her accepted knee conditions, the 

Board finds that appellant has not met her burden of proof.

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.

LEGAL PRECEDENT -- ISSUE 2

Where an employee claims that a condition not accepted or approved by OWCP was due 

to an employment injury, he or she bears the burden of proof to establish that the condition is 

causally related to the employment injury.19 

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

establish causal relationship is rationalized medical opinion evidence.20 To establish causal 

relationship between the condition as well as any attendant disability claimed and the employment 

injury, an employee must submit rationalized medical evidence supporting causal relationship.21 

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.22 

Neither the mere fact that a disease or condition manifests itself during a period of 

employment, nor the claimant’s own belief that the disease or condition was caused or aggravated 

by employment factors or incidents is sufficient to establish causal relationship.23

 

18 5 U.S.C. § 8102(2) of FECA provides that the term physician includes surgeons, podiatrists, dentists, clinical 

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

by State law. 5 U.S.C. § 8101(2); 20 C.F.R. § 10.404; R.V., Docket No. 18-1037 (issued March 26, 2019); E.T.,

Docket No. 17-0265 (issued May 25, 2018) (physician assistants are not considered physicians under FECA); C.P., 

Docket No. 17-0042 (issued December 27, 2016); David P. Sawchuk, 57 ECAB 316, 320 n.11 (2006); Roy L. 

Humphrey, 57 ECAB 238 (2005).

19 R.K., Docket No. 18-1409 (issued April 15, 2019); see T.F., Docket No. 17-0645 (issued August 15, 

2018); Jana K. Asaramo, 55 ECAB 200 (2004).

20 See D.V., supra note 14. 

21 R.K., supra note 19; see S.A., Docket No. 18-0399 (issued October 16, 2018); Leslie C. Moore, 52 ECAB 

132 (2000).

22 Id.

23 C.P., Docket No. 18-1645 (issued March 8, 2019); Dennis M. Mascarenas, 49 ECAB 215 (1997).
6

ANALYSIS -- ISSUE 2

The Board finds that appellant has not met her burden of proof to expand the acceptance

of her claim to include spinal stenosis, spondylolisthesis, and sacroiliac joint osteoarthritis as 

causally related to the accepted May 1, 2018 employment injury.

In his September 10, 2018 report, Dr. Rankin noted a history of appellant’s accepted injury

and provided examination findings based on diagnostic testing. He diagnosed spinal stenosis of 

lumbar region with neurogenic claudication, spondylolisthesis, and osteoarthritis of sacroiliac 

joint. However, Dr. Rankin did not address the causal nature of these additional diagnoses. The 

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

employee’s condition is of no probative value on the issue of causal relationship.24 Thus, this 

evidence is insufficient to meet appellant’s burden of proof.

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 July 7, 2018 and continuing causally related to her accepted May 1, 2018 

employment injury. The Board also finds that she has not met her burden of proof to expand the

acceptance of her claim to include additional conditions of spinal stenosis, spondylolisthesis, and 

sacroiliac joint osteoarthritis as causally related to the accepted May 1, 2018 employment injury.

 

24 T.K., Docket No. 18-1239 (issued May 29, 2019). 
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ORDER

IT IS HEREBY ORDERED THAT the October 23, 2018 decisions of the Office of 

Workers’ Compensation Programs are affirmed.

Issued: August 9, 2019

Washington, DC

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board