United States Department of Labor

Employees’ Compensation Appeals Board

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H.M., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Charlotte, NC, Employer

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Docket No. 18-0303

Issued: July 16, 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

PATRICIA H. FITZGERALD, Deputy Chief Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On November 27, 2017 appellant filed a timely appeal from an October 23, 2017 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 a right knee condition 

causally related to the accepted September 13, 2017 employment incident.

 

1 5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY

On September 13, 2017 appellant, then a 31-year-old city carrier, filed a traumatic injury 

claim (Form CA-1) alleging that on that date she sustained a right knee contusion when she hit her 

knee on the steel corner of the loading dock. She did not stop work.

In a September 13, 2017 work status note, William Carlton Cabaniss, a certified physician 

assistant, diagnosed right knee contusion and provided work restrictions.

In a development letter dated September 19, 2017, OWCP advised appellant that additional 

evidence was needed to establish her claim. This included a narrative medical report from a 

physician, which provided a diagnosis and an opinion supported by a medical explanation as to 

how the reported work incident caused or aggravated a medical condition. OWCP afforded 

appellant 30 days to submit the requested medical evidence.

In a September 13, 2017 report, Mr. Cabaniss noted that appellant was seen for complaints 

of right knee pain since a September 13, 2017 work injury. Appellant related that the injury was 

associated with blunt force trauma. A physical examination revealed abnormal right knee findings. 

Mr. Cabaniss diagnosed a right knee contusion and released appellant to return to work with 

restrictions.

A September 16, 2017 x-ray of the right knee read by Dr. James A. Cain, III, a diagnostic 

radiologist, revealed no fracture or other acute finding. 

A September 16, 2017 report signed by Crystal Marie Clark, a certified physician assistant, 

diagnosed a right knee contusion. Ms. Clark provided a history of injury, reviewed an x-ray, and 

noted physical examination findings, which included right knee tenderness, abrasion and 

rash/small ecchymosis noted. She released appellant to return to duty that day with restrictions.

In September 13 and 16, 2017 work status notes and a September 16, 2017 patient clinical 

summary, Ms. Clark diagnosed right knee contusion and provided work restrictions. The record 

also contains a report dated September 23, 2017 and signed by Newton High, a physician assistant. 

Mr. High noted the history of injury, detailed examination findings, which included right knee 

tenderness, and diagnosed right knee contusion. He noted that appellant could return to work on 

October 2, 2017. 

In a September 23, 2017 work status note, Mr. High diagnosed right knee contusion. He 

noted that appellant was currently not working and could return on October 2, 2017.

By decision dated October 23, 2017, OWCP denied appellant’s traumatic injury claim. It 

accepted that the September 13, 2017 incident occurred as alleged, but denied the claim as 

appellant failed to establish that a medical condition was diagnosed in connection with the 

September 13, 2017 incident and; therefore, she did not establish an employment-related injury. 
3

LEGAL PRECEDENT

An employee seeking benefits under FECA2 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.3 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.4

To determine whether a federal employee has sustained a traumatic injury in the 

performance of duty it must first be determined whether fact of injury has been established.5 First, 

the employee must submit sufficient evidence to establish that he or she actually experienced the 

employment incident at the time, place, and in the manner alleged.6 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.7

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

establish causal relationship is rationalized medical opinion evidence.8 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.9 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.10 

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

therapists, and social workers are not considered “physician[s]” as defined under FECA.11 

 

2

Id.

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

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

5 B.F., Docket No. 09-0060 (issued March 17, 2009); Bonnie A. Contreras, supra note 3.

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

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

note 3.

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

642 (2006).

9

J.J., Docket No. 09-0027 (issued February 10, 2009); Michael S. Mina, 57 ECAB 379 (2006).

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

11 5 U.S.C. § 8101(2); 20 C.F.R. § 10.5(t).
4

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

entitlement to FECA benefits.12

ANALYSIS

The Board finds that OWCP properly determined that appellant has not established an 

injury causally related to the accepted September 13, 2017 employment incident.

Appellant submitted medical reports, work status notes, and patient clinical summaries 

dated September 13, 16, and 23, 2017, signed by physician assistants. The Board has consistently 

held that physician assistants are not considered a physician as defined under FECA and are not 

competent to render a medical opinion.13 This evidence is, therefore, of no probative value.14

The only other medical evidence submitted was Dr. Cain’s September 16, 2017 diagnostic 

report, which noted that a right knee x-ray revealed no fracture or other acute finding. As Dr. Cain 

provided findings that appellant’s diagnostic testing was normal, his report provides no support 

for an injury and is insufficient to establish a medical diagnosis.15 

Absent a specific injury-related diagnosis from a qualified physician, appellant has failed 

to establish an injury causally related to the accepted September 13, 2017 employment incident. 

Accordingly, she has failed to meet 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.

CONCLUSION

The Board finds that appellant has not met her burden of proof to establish a right knee 

condition causally related to the accepted September 13, 2017 employment incident.

 

12 Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.805.3(a)(1) (January 2013). 

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

13 K.G., Docket No. 17-2022 (issued March 7, 2018); Sean O’Connell, 56 ECAB 195 (2004) (physician assistants

are not considered physicians under FECA).

14 See supra note 12.

15 J.P., Docket No. 14-0087 (issued March 14, 2014).
5

ORDER

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

Programs dated October 23, 2017 is affirmed.

Issued: July 16, 2018

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board