United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

A.T., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Cartersville, GA, Employer

__________________________________________

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Docket No. 18-0221

Issued: June 7, 2018

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 March 17, 20171appellant filed a timely appeal from a February 14, 2017 merit 

decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to the Federal 

Employees’ Compensation Act2(FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board has 

jurisdiction to consider the merits of the case.

 

1 Under the Board’s Rules of Procedure, an appeal must be filed within 180 days from the date of the last OWCP 

decision. An appeal is considered filed upon receipt by the Clerk of the Appellate Boards. One hundred and eighty 

days from February 14, 2017, the date of OWCP’s most recent merit decision, was August 13, 2017. Since using 

November 8, 2017, the date the appeal was received by the Clerk of the Board, would result in the loss of appeal 

rights, the date of the postmark is considered the date of filing. The date of the U.S. Postal Service postmark is 

March 17, 2017, which renders the appeal timely filed. See 20 C.F.R. § 501.3(f)(1).

2 5 U.S.C. § 8101 et seq.
2

ISSUE

The issue is whether appellant has met his burden of proof to establish degenerative cuff 

tear of the right shoulder causally related to the accepted October 22, 2016 employment incident.

FACTUAL HISTORY

On November 7, 2016 appellant, then a 65-year-old mail carrier, filed a traumatic injury 

claim (Form CA-1) alleging that on October 22, 2016 he injured his right shoulder while 

repetitively pulling on mailboxes and lifting mail and parcels while in the performance of duty. 

He stopped work on October 24, 2016. In support of his claim, appellant provided an October 26, 

2016 note from Susan E. Deguia, a nurse practitioner.

In a November 23, 2016 development letter, OWCP requested additional factual and 

medical evidence in support of appellant’s claim and provided him with a questionnaire. It

informed appellant that evidence from a physician assistant or nurse practitioner was insufficient 

to establish his claim. OWCP afforded appellant 30 days for a response.

Appellant provided additional documentation from Ms. Deguia including a November 4, 

2016 authorization for examination and/or treatment (Form CA-16). He completed OWCP’s 

questionnaire on December 6, 2016 and described his work duties on October 22, 2016, including 

opening and closing mailbox lids to deposit mail into the boxes. Appellant noted that his route 

included over 600 mailboxes and that some lids could be stuck and harder to open requiring a tug 

to pull the lid open.

On December 13, 2016 Dr. Leverett Neville, a radiologist, conducted a magnetic resonance 

imaging (MRI) scan of appellant’s right shoulder. He found a near full-thickness tear of the 

anterior margin of the supraspinatus involving the bursal and articular surface, moderate 

degenerative changes of the acromioclavicular joint, and edema.

By decision dated December 28, 2016, OWCP denied appellant’s traumatic injury claim,

finding that appellant had not provided medical evidence establishing that a medical diagnosis was 

causally related to the accepted employment incident.

On February 1, 2017 appellant requested reconsideration and provided additional medical 

evidence. In a report dated January 15, 2017, Dr. Jayson Fields, a Board-certified family 

practitioner, explained that he had first examined appellant on October 27, 2016 due to shoulder 

pain with limited range of motion. Appellant informed him that on October 22, 2016, partway 

through his delivery route, he had felt a pull in his shoulder while putting mail in one of the boxes. 

Dr. Fields noted that, as there was no history of acute trauma, appellant’s condition was most 

consistent with completion of a degenerative cuff tear. He concluded, “[d]egenerative tears most 

often are related to work habits and rather indolent until the sudden completion of the tear. The 

final tear may occur while doing regular daily activities.” Dr. Fields completed a form report on 

December 23, 2016 and diagnosed supraspinatus tear and degenerative acromioclavicular joint 

bursitis.
3

By decision dated February 14, 2017, OWCP modified its December 28, 2016 decision to 

reflect that appellant had established the medically-diagnosed condition of right shoulder 

degenerative cuff tear. However, the claim remained denied as appellant had not submitted 

sufficient reasoned medical evidence to establish causal relationship between his accepted 

employment incident on October 22, 2016 and his diagnosed right shoulder degenerative cuff tear.

LEGAL PRECEDENT

An employee seeking benefits under FECA3 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 of FECA, that an injury was sustained 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. These are the essential elements of each and every compensation claim 

regardless of whether the claim is predicated upon 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 first must be determined whether fact of injury has been established. There 

are two components involved in establishing fact of injury. 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. Second, the employee must submit medical evidence to 

establish that the employment incident caused a personal injury.5

Rationalized medical opinion evidence is generally required to establish causal 

relationship. The opinion of the physician must be based on a complete factual and medical 

background, 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 claimant.6 This medical opinion must include an accurate 

history of the employee’s employment injury and must explain how the condition is related to the 

injury. The weight of medical evidence is determined by its reliability, its probative value, its 

convincing quality, the care of analysis manifested, and the medical rationale expressed in support 

of the physician’s opinion.7

 

3 Supra note 1.

4 A.D., Docket No. 17-1855 (issued February 26, 2018); Gary J. Watling, 52 ECAB 357 (2001).

5 A.D., id.; T.H., 59 ECAB 388 (2008).

6 A.D., supra note 4; I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 ECAB 345 (1989).

7 S.H., Docket No. 17-1660 (issued March 27, 2018); James Mack, 43 ECAB 321 (1991).
4

ANALYSIS

The Board finds that appellant has not met his burden of proof to establish degenerative 

cuff tear of the right shoulder causally related to the accepted October 22, 2016 employment 

incident.

It is undisputed that on October 22, 2016 appellant performed his work duties of 

repetitively pulling on mailboxes as well as lifting mail and parcels. However, the Board finds 

that he failed to submit sufficient medical evidence to establish that this work incident caused or 

aggravated his right shoulder condition.8 

In support of his claim, appellant submitted medical evidence from Dr. Fields dated 

December 23, 2016 and January 15, 2017. Dr. Fields described appellant’s employment activities 

on October 22, 2016 and noted that appellant felt a pull in his shoulder while putting mail in one 

of the boxes. He indicated that he first examined appellant on October 27, 2016 due to shoulder 

pain and diagnosed completion of a degenerative cuff tear at the supraspinatus tendon as well as 

degenerative acromioclavicular joint bursitis. Dr. Fields opined that the completion of a rotator 

cuff tear could occur while performing regular daily activities. The Board finds that the opinion 

of Dr. Fields is not well rationalized. While Dr. Fields suggested that appellant’s injuries were 

caused by the October 22, 2016 employment incident, he failed to provide a sufficient explanation 

as to the mechanism of injury pertaining to this traumatic injury claim, namely, how putting mail 

into boxes would cause or aggravate appellant’s shoulder condition.9 Dr. Fields noted that 

completion of a rotator cuff tear can occur with daily activities. The Board finds this statement to 

be vague and generalized without sufficient detail explaining how appellant’s work activities 

caused his injury.10 Medical reports without adequate rationale on causal relationship are of 

diminished probative value and do not meet an employee’s burden of proof.11 The opinion of a 

physician supporting causal relationship must rest on a complete factual and medical background 

supported by affirmative evidence, address the specific factual and medical evidence of record, 

and provide medical rationale explaining the relationship between the diagnosed condition and the 

established incident or factor of employment.12 Without explaining how physiologically the 

movements involved in the employment incident caused or contributed to the diagnosed condition,

Dr. Fields’ opinion on causal relationship is equivocal in nature and of limited probative value.13

 

8 M.E., Docket No. 17-1857 (issued February 2, 2018).

9 S.H., supra note 7; S.W., Docket No. 08-2538 (issued May 21, 2009).

10 Id.

11 S.H., supra note 7; Ceferino L. Gonzales, 32 ECAB 1591 (1981).

12 S.H., id.; Lee R. Haywood, 48 ECAB 145 (1996).

13 S.H., supra note 7; L.M., Docket No. 14-0973 (issued August 25, 2014); R.G., Docket No. 14-0113 (issued 

April 25, 2014); K.M., Docket No. 13-1459 (issued December 5, 2013); A.J., Docket No. 12-0548 (issued 

November 16, 2012).
5

Appellant also submitted a December 13, 2016 right shoulder MRI scan. Medical evidence 

of diagnostic testing is of limited probative value as it fails to provide a physician’s opinion on 

causal relationship between appellant’s work incident and the diagnosed conditions.14

Appellant submitted reports from a nurse practitioner. However, the Board has held that 

reports by a nurse practitioner are not considered medical evidence as this care provider is not 

considered a physician under FECA.15 

An award of compensation may not be based on surmise, conjecture, speculation, or on the 

employee’s own belief of causal relation.16 Appellant’s honest belief that the October 22, 2016

employment incident caused his medical conditions, however, sincerely held, does not constitute 

the medical evidence to establish causal relationship.17

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 10.607.18

CONCLUSION

The Board finds that appellant has not met his burden of proof to establish degenerative 

cuff tear of the right shoulder causally related to the accepted October 22, 2016 employment 

incident.

 

14 See M.S., Docket No. 17-1044 (issued February 2, 2018).

15 See F.M., Docket No. 16-1848 (issued March 16, 2018); 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).

16 G.E., Docket No. 17-1719 (issued February 6, 2018); D.D., 57 ECAB 734 (2006).

17 G.E, id.; H.H., Docket No. 16-0897 (issued September 21, 2016).

18 The Board notes that the employing establishment executed a Form CA-16 on November 4, 2016 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. Although OWCP denied appellant’s claim for an injury, it did not address 

whether she is entitled to reimbursement of medical expenses pursuant to the Form CA-16. See S.H., supra note 7; 

I.S., Docket No. 16-1813 (issued March 16, 2015).
6

ORDER

IT IS HEREBY ORDERED THAT the February 14, 2017 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: June 7, 2018

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