United States Department of Labor

Employees’ Compensation Appeals Board

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K.T., Appellant

and

DEPARTMENT OF THE INTERIOR, BUREAU 

OF RECLAMATION, Denver, CO, Employer

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Docket No. 19-0228

Issued: June 12, 2019

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 November 8, 2018 appellant filed a timely appeal from a June 18, 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 over 

the merits of this case.2

ISSUE

The issue is whether appellant has met her burden of proof to establish a traumatic injury 

causally related to the accepted February 22, 2018 employment incident.

 

1 5 U.S.C. § 8101 et seq.

2 The Board notes that on appeal appellant submitted additional evidence. However, section 501.2(c)(1) of 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 evidence for 

the first time on appeal. Id.
2

FACTUAL HISTORY

On February 26, 2018 appellant, then a 39-year-old technical information specialist, filed 

a traumatic injury claim (Form CA-1) alleging that on February 22, 2018 she sustained an injury 

to her right knee, chin, and right hand when she fell as her shoe became stuck on exposed carpet 

glue while in the performance of duty. She did not stop work. 

In a February 27, 2018 report, Dr. Krystyna Lindenmuth, a Board-certified family 

practitioner, indicated that she saw appellant on February 26, 2018 after she presented for followup care for a hand fracture. She noted that appellant accidentally fell on her right hand at work a 

few days earlier. Dr. Lindenmuth assessed “[c]losed nondisplaced fracture of shaft of fifth 

metacarpal bone of right hand.”

In a development letter dated May 18, 2018, OWCP acknowledged receipt of appellant’s 

claim and informed her that additional evidence was needed to establish her claim. It advised her 

of the type of factual and medical evidence needed and provided a questionnaire for her 

completion. By separate letter of even date, OWCP also requested additional information from 

the employing establishment. It afforded appellant and the employing establishment 30 days to 

respond. No response was received. 

By decision dated June 18, 2018, OWCP accepted that the February 22, 2018 employment 

incident occurred as alleged, but denied appellant’s claim, finding that she had not submitted

evidence containing a medical diagnosis from a qualifying physician in connection with the 

accepted employment incident. Specifically, it noted that the medical evidence of record included 

a February 27, 2018 report from “Krystyna Lindenmuth, RMPC” and explained that nurses and 

nurse practitioners are not considered qualified physicians under FECA, thus appellant had not 

satisfied the medical component of fact of injury and therefore had not met the requirements for 

establishing an injury as defined by FECA. 

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 timely filed within the applicable 

time limitation period of FECA,4that an injury was sustained in the performance of duty as alleged, 

and that any disability or medical condition for which compensation is claimed is causally related 

 

3 Supra note 1.

4 S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59 ECAB 178 (2007); Joe D. Cameron, 41 ECAB 

153 (1989).
3

to the employment injury.5 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.6

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

OWCP begins with an analysis of whether fact of injury has been established.7 Generally, fact of 

injury consists of two components that must be considered in conjunction with one another. First, 

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

employment incident at the time, place, and in the manner alleged.8 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.9

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

relationship is rationalized medical evidence.10 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.11

ANALYSIS

The Board finds that this case is not in posture for decision. 

OWCP denied appellant’s traumatic injury claim finding that the evidence of record did 

not contain a medical diagnosis from a qualified physician, noting that the available evidence was 

from a nurse or nurse practitioner and that nurses are not considered qualified physicians under 

FECA.12 It correctly noted that nurses and nurse practitioners are not qualified physicians, 

 

5

J.M., Docket No. 17-0284 (issued February 7, 2018); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40 

ECAB 312 (1988).

6 K.M., Docket No. 15-1660 (issued September 16, 2016); L.M., Docket No. 13-1402 (issued February 7, 2014); 

Delores C. Ellyett, 41 ECAB 992 (1990).

7 D.B., Docket No. 18-1348 (issued January 4, 2019); T.H., 59 ECAB 388, 393-94 (2008).

8 S.F., Docket No. 18-0296 (issued July 26, 2018); D.B., 58 ECAB 464 (2007); David Apgar, 57 ECAB 137 (2005).

9 A.D., Docket No. 17-1855 (issued February 26, 2018); C.B., Docket No. 08-1583 (issued December 9, 2008); 

D.G., 59 ECAB 734 (2008); Bonnie A. Contreras, 57 ECAB 364 (2006).

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

11 K.V., Docket No. 18-0723 (issued November 9, 2018); Leslie C. Moore, 52 ECAB 132 (2000); Gary L. Fowler, 

45 ECAB 365 (1994).

12 See 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); see also 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); S.J., Docket No. 17-0783, 

n.2 (issued April 9, 2018) (nurse practitioners are not considered physicians under FECA); 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).
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however, it misidentified Dr. Krystyna Lindenmuth, a Board-certified family practitioner, as a 

nurse or nurse practitioner. 

In its June 18, 2018 decision denying appellant’s claim, OWCP indicated that it received a 

February 27, 2018 report from “Krystyna Lindenmuth, RMPC.” The Board notes that the report 

indicated that appellant saw “Krystyna Lindenmuth MD” during her office visit at Rocky 

Mountain Primary Care, which the report abbreviated as “RMPC” and identifies as

Dr. Lindenmuth’s clinical affiliation. In the report, Dr. Lindenmuth provides a firm diagnosis of 

fifth metacarpal bone fracture of the right hand and opines that appellant’s injury occurred as a 

result of an accident at work a few days prior. 

Accordingly, the Board finds that appellant has established a diagnosed medical condition. 

OWCP’s June 18, 2018 decision shall be set aside and the case remanded. On remand, following 

such further development as may be deemed necessary, OWCP shall issue a de novo decision on 

the issue of casual relationship.

CONCLUSION

The Board finds the case is not in posture for decision.

ORDER

IT IS HEREBY ORDERED THAT the June 18, 2018 decision of the Office of Workers’

Compensation Programs is set aside and the case is remanded for further action consistent with 

this decision of the Board.

Issued: June 12, 2019

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