United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

T.T., Appellant

and

DEPARTMENT OF HOMELAND SECURITY, 

TRANSPORTATION SECURITY 

ADMINISTRATION, Houston, TX, Employer

__________________________________________

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Docket No. 19-1121

Issued: November 18, 2019

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

PATRICIA H. FITZGERALD, Deputy Chief Judge

JANICE B. ASKIN, Judge

ALEC J. KOROMILAS, Alternate Judge

JURISDICTION

On April 22, 2019 appellant, through counsel, filed a timely appeal from a March 13, 2019 

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 over the merits of this case.

ISSUE

The issue is whether appellant has met her burden of proof to establish a left shoulder 

condition causally related to the accepted March 28, 2018 employment incident.

 

1

In all cases in which a representative has been authorized in a matter before the Board, no claim for a fee for legal 

or other service performed on appeal before the Board is valid unless approved by the Board. 20 C.F.R. § 501.9(e). 

No contract for a stipulated fee or on a contingent fee basis will be approved by the Board. Id. An attorney or 

representative’s collection of a fee without the Board’s approval may constitute a misdemeanor, subject to fine or 

imprisonment for up to one year or both. Id.; see also 18 U.S.C. § 292. Demands for payment of fees to a 

representative, prior to approval by the Board, may be reported to appropriate authorities for investigation.

2 5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY

On March 28, 2018 appellant, then a 54-year-old transportation security officer, filed a 

traumatic injury claim (Form CA-1) alleging that on March 28, 2018 she sustained a left shoulder 

strain when pulling and lifting passenger bags while in the performance of duty. She stopped work 

on that date. 

In an April 17, 2018 report, Dr. Richard Trifiro, a family medicine specialist, noted that 

appellant presented for a follow-up evaluation of the left shoulder injury sustained on 

March 28, 2018. He indicated that she continued to complain of pain, but that she was improving. 

Dr. Trifiro diagnosed strain of left trapezius muscle and strain of left shoulder and provided work 

restrictions of lifting 15 pounds constantly, pushing and pulling 25 pounds constantly, and no 

reaching above shoulders.

In an April 30, 2018 development letter, OWCP requested that appellant provide additional 

factual and medical evidence in support of her claim, including a detailed factual statement and a 

report from her attending physician addressing the causal relationship between any diagnosed 

condition(s) and the claimed March 28, 2018 work incident. It afforded her 30 days to provide 

additional evidence. 

In response, appellant submitted two narrative statements dated May 17, 2018 indicating 

that she was pulling passenger bags up to the conveyor belt and lifting them with the handle onto 

the belt to be x-rayed. She stated that the bags weighed as much as 50 to 100 pounds and she was 

alternating, using both arms. At approximately 8:00 a.m., appellant felt a pop in her left shoulder 

and when she continued to experience pain she informed her supervisor. 

Appellant also submitted progress reports dated March 28, April 24, May 1 and 22, 2018 

from Dr. Trifiro, who asserted that appellant injured her left shoulder on March 28, 2018 while 

lifting heavy baggage at work, felt a shooting pain, and could not lift her arm fully. Dr. Trifiro

diagnosed adhesive capsulitis of the left shoulder and continued his previously provided work 

restriction.

On May 8, 2018 Dr. John Dang, a Board-certified orthopedic surgeon, diagnosed strain of 

left shoulder and adhesive capsulitis of the left shoulder and provided work restrictions of lifting 

up to 20 pounds constantly, pushing and pulling up to 25 pounds constantly, and no overhead 

lifting. 

In a letter dated May 29, 2018, the employing establishment controverted appellant’s claim 

and argued that video footage confirmed that she did not utilize her left arm/hand/shoulder for the 

entire period of time she was working prior to reporting the alleged injury on March 28, 2018. It 

also noted that she was under administrative review for disciplinary action resulting in proposed 

suspension due to inappropriate behavior while in the performance of duty. The employing 

establishment enclosed a compact disc (CD) file of the surveillance footage. 

Appellant subsequently submitted physical therapy treatment notes dated March 30, 2018 

in support of her claim.

In progress reports dated April 3 and 10, May 29, and June 8, 2018, Dr. Trifiro reiterated 

his diagnoses and work restrictions. 
3

By decision dated August 3, 2018, OWCP found that the factual evidence of record was 

insufficient to establish that the March 28, 2018 incident occurred at the time, place, and in the

manner alleged. 

On August 23, 2018 appellant, through counsel, requested a hearing before a representative 

of OWCP’s Branch of Hearings and Review. Counsel also submitted chart notes dated June 18 to 

July 13, 2018 from appellant’s chiropractor, Dr. Paul M. Raymond, who observed edema/swelling, 

tenderness, and muscle weakness in the left anterior shoulder region. He also submitted a July 25, 

2018 report from Dr. Raymond regarding his examination of appellant’s right shoulder. 

In a July 17, 2018 report, Dr. Dominic G. Sreshta, a Board-certified internist and hospice 

care and palliative medicine specialist, diagnosed strain of unspecific muscle, fascia and tendon at 

shoulder and upper arm level, left arm and adhesive capsulitis of the left shoulder. He reported 

that appellant recounted that she was injured while performing her normal work duties at her 

normal capacity.

A telephonic hearing was held before an OWCP hearing representative of the Branch of 

Hearings and Review on January 3, 2019. 

By decision dated March 13, 2019, OWCP’s hearing representative affirmed, as modified, 

the prior decision. OWCP accepted that she was lifting and sliding bags on March 28, 2018 and 

although she predominately used her right arm, she also used her left arm in the performance of 

duty. It determined, however, that the medical evidence of record was insufficient to establish that 

she sustained a diagnosed condition causally related to the accepted work incident. 

LEGAL PRECEDENT

An employee seeking benefits under FECA3 has the burden of proof to establish the 

essential elements of his or her claim by the weight of the reliable, probative, and substantial 

evidence, including the fact that the individual is an employee of the United States within the 

meaning of FECA, that the claim was timely filed within the applicable time limitation period 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.4 These are the essential elements of 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 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 

 

3

Id.

4 K.V., Docket No. 18-0947 (issued March 4, 2019); M.E., Docket No. 18-1135 (issued January 4, 2019); Kathryn 

Haggerty, 45 ECAB 383, 388 (1994).

5 K.V. and M.E., id.; Elaine Pendleton, 40 ECAB 1143 (1989).
4

time, place, and in the manner alleged.6 Second, the employee must submit medical evidence to 

establish that the employment incident caused a personal injury.7

Causal relationship is a medical question that requires rationalized medical opinion 

evidence to resolve the issue.8 A physician’s opinion on whether there is causal relationship 

between the diagnosed condition and the implicated employment factor(s) must be based on a 

complete factual and medical background.9 Additionally, the physician’s opinion must be 

expressed in terms of a reasonable degree of medical certainty, and must be supported by medical 

rationale explaining the nature of the relationship between the diagnosed condition and appellant’s 

specific employment factor(s).10

ANALYSIS

The Board finds that appellant has not met her burden of proof to establish a left shoulder 

condition causally related to the accepted March 28, 2018 employment incident.

In support of her claim, appellant submitted a series of notes from Dr. Trifiro and a report 

by Dr. Sreshta. Dr. Trifiro and Dr. Sreshta diagnosed left shoulder conditions and indicated that 

appellant recounted that she was injured while performing her normal work duties. These reports, 

however, do not provide an opinion as to causal relationship between the accepted March 28, 2018 

employment incident and the diagnosed conditions. 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 on the issue of causal relationship.11 These reports, therefore, are insufficient to establish 

appellant’s claim. 

Likewise, appellant also submitted evidence from Dr. Dang, who diagnosed strain and 

adhesive capsulitis of the left shoulder on May 8, 2018, and Dr. Raymond, who observed 

edema/swelling, tenderness, and muscle weakness in the left anterior shoulder region and 

previously examined appellant for a right shoulder condition. The Board further finds that neither 

of these physicians addressed causal relationship and thus their reports are of no probative value 

and insufficient to meet appellant’s burden of proof.12

Appellant further submitted physical therapy treatment notes. The Board has held that 

medical reports signed solely by a physical therapist are of no probative value as such health care 

providers are not considered physicians as defined under FECA and are therefore not competent 

 

6 G.C., Docket No. 18-0506 (issued August 15, 2018).

7

Id.

8 T.H., 59 ECAB 388, 393 (2008); Robert G. Morris, 48 ECAB 238 (1996).

9 M.V., Docket No. 18-0884 (issued December 28, 2018).

10 Id.; Victor J. Woodhams, 41 ECAB 345, 352 (1989).

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

12 Id. 
5

to provide medical opinions.13 Consequently, this evidence is also insufficient to establish 

appellant’s claim.

As appellant has not submitted rationalized medical evidence sufficient to establish an 

injury causally related to the accepted employment incident, the Board finds that she 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.

CONCLUSION

The Board finds that appellant has not met her burden of proof to establish a left shoulder 

condition causally related to the accepted March 28, 2018 employment incident.

ORDER

IT IS HEREBY ORDERED THAT the March 13, 2019 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: November 18, 2019

Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate Judge

Employees’ Compensation Appeals Board

 

13 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); J.M., 58 ECAB 448 (2007) (physical 

therapists are not considered physicians under FECA).