United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

V.V., Appellant

and

U.S. POSTAL SERVICE, CHURCHVILLE 

POST OFFICE, Churchville, NY, Employer

__________________________________________

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Docket No. 20-0175

Issued: May 22, 2020

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

JANICE B. ASKIN, Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On October 29, 2019 appellant filed a timely appeal from an August 23, 2019 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.

ISSUE

The issue is whether appellant has met her burden of proof to establish a medical condition 

causally related to the accepted November 30, 2018 employment incident.

FACTUAL HISTORY

On November 30, 2018 appellant, then a 54-year-old rural carrier, filed a traumatic injury 

claim (Form CA-1) alleging that on that day she sustained sprains to her right wrist, shoulder, and 

 

1 5 U.S.C. § 8101 et seq.
2

lower back when she tripped over packages while in the performance of duty. She stopped work

on December 1, 2018. 

In a November 30, 2018 authorization for examination and/or treatment (Form CA-16), the 

employing establishing authorized appellant to seek medical care at an urgent care facility. 

In a December 1, 2018 medical report, Andrew K. Polla, a physician assistant, noted that 

appellant was treated that day and advised that she should not return to work until cleared by an 

orthopedic physician. In a subsequent report dated December 3, 2018, Timothy Nervina, a nurse 

practitioner, also noted that she was seen on December 1, 2018 and sustained an injury to her 

shoulder when she fell at work. He advised that appellant should not return to work until cleared 

by a physician. 

In a December 12, 2018 letter, the employing establishment controverted appellant’s claim

asserting that it had witness statements from employees that were present on the date of the alleged 

employment incident, but they did not observe or hear her fall as alleged. 

A continuation of pay nurse report dated December 20, 2018 indicated that appellant 

remained off work due to right wrist and shoulder sprains. 

In a development letter dated December 21, 2018, OWCP informed appellant of the 

deficiencies in her claim. It advised her of the factual and medical evidence necessary to establish 

her claim and provided a factual questionnaire for completion. OWCP afforded appellant 30 days 

to submit the necessary evidence. 

In a December 4, 2018 witness statement, T.C., appellant’s coworker, stated that appellant

was working all day on November 30, 2018 and did not see or hear her fall that day. 

In another witness statement of even date, G.R., appellant’s coworker, noted that his 

workstation was adjacent to appellant’s workstation, and although he could hear most of the things 

that, transpired in her work area, he did not hear or see her fall on November 30, 2018. He also 

noted that he observed her the following day talking on the cellphone while using her injured 

shoulder to hold the cellphone to her ear. G.R., asserted that appellant did not appear to be in pain 

and her work did not seem to be affected by her alleged injury. 

In an undated statement, appellant contended that she injured herself on the morning of 

November 30, 2018 while working when the tip of her boot caught alongside one of the mail 

packages that were on the floor, causing her to fall. She explained that there was a high volume 

of packages that day stacked on the floor around her case and that the individuals that provided 

witness statements would not have been able to see her when she fell, as they would have been 

working in their own cases at the time of her fall. Appellant further alleged that after she stood up 

from her fall she saw no one in her area. 

In a December 14, 2018 medical report, Dr. Michael C. Stanton, Board-certified in sports 

medicine, noted that appellant presented complaining of pain in the right shoulder, moderate neck 

pain, and occasional numbness and tingling down her right upper extremity. Appellant related that 

she was injured when she fell directly onto her right shoulder while at work on 

November 30, 2018. On physical examination of the right shoulder, Dr. Stanton noted full 
3

strength, no tenderness on palpitation, and a positive Neer and Hawkins tests. He also reviewed 

appellant’s right shoulder x-ray, which revealed well-preserved joint spaces throughout with no 

obvious fracture or dislocation. Dr. Stanton diagnosed cervical radiculopathy and opined that her

current symptoms appeared to be mostly related to her cervical spine and that she might have some 

mild impingement in her shoulder, which was improving with conservative treatment. 

In a January 7, 2019 medical report, Dr. Matthew Kruppenbacher, Board-certified in 

physical medicine, conducted a physical examination and opined that she could return to work as 

of that day with restrictions of no repetitive pulling, pushing, overhead reaching, or lifting greater 

than 15 pounds. 

In a January 16, 2019 work status report (Form CA-3), the employing establishment 

advised OWCP that appellant had returned to part-time limited-duty work on January 14, 2019. 

By decision dated January 24, 2019, OWCP denied appellant’s claim finding that she had 

not established the factual component of her claim It concluded, therefore, that the requirements 

had not been met to establish an injury as defined by FECA. 

On July 11, 2019 appellant requested reconsideration. 

In support of her request, appellant submitted a May 14, 2019 medical report from

Dr. Kruppenbacher wherein he noted that she had no previous history of symptoms prior to the 

claimed November 30, 2018 employment incident when she fell directly onto her right shoulder 

after tripping over packages. Dr. Kruppenbacher indicated that she experienced an immediate 

onset of symptoms in her right medial upper scapular region, right deltoid, and right posterior arm. 

He further noted that appellant’s condition had since improved and she had been working without 

restrictions since February 4, 2019. Dr. Kruppenbacher diagnosed cervical radiculopathy, 

cervicalgia, and numbness. He responded “yes” regarding whether he believed that the 

November 30, 2018 employment incident caused appellant’s injury and that her history of the 

injury was consistent with his objective findings. 

By decision dated August 23, 2019, OWCP modified its prior decision finding that 

appellant had established both the factual and medical components of fact of injury. However, 

appellant’s claim remained denied because the medical evidence of record was insufficient to 

establish that her diagnosed cervical radiculopathy was causally related to the accepted 

November 30, 2018 employment incident. 

LEGAL PRECEDENT

An employee seeking benefits under FECA2 has the burden of proof to establish the 

essential elements of his or her claim, including 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 of FECA,3that an injury was sustained in the performance of duty as alleged, and that 

 

2

Id.

3

J.P., Docket No. 19-0129 (issued April 26, 2019); F.H., Docket No.18-0869 (issued January 29, 2020); Joe D. 

Cameron, 41 ECAB 153 (1989). 
4

any disability or medical condition for which compensation is claimed is causally related to the 

employment injury.4 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.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 

time, place, and in the manner alleged. The second component is whether the employment incident 

caused a personal injury and can be established only by medical evidence.6 

The medical evidence required to establish a causal relationship between a claimed specific 

condition and an employment incident is rationalized medical opinion evidence.7 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 specific employment factors 

identified by the employee.8

ANALYSIS

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

condition causally related to the accepted November 30, 2018 employment incident. 

In a December 14, 2018 medical report, Dr. Stanton noted that appellant reported 

experiencing right shoulder pain after directly falling onto her right shoulder at work on 

November 30, 2018. He diagnosed cervical radiculopathy. However, Dr. Stanton did not provide 

an opinion on the cause of appellant’s diagnosed condition. Similarly, in his January 7, 2019 

medical report, Dr. Kruppenbacher opined that she could return to work with restrictions. 

However, he did not provide a diagnosis or offer an opinion regarding the cause of appellant’s 

condition. The Board has long 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.9 

Thus, Dr. Stanton’s December 14, 2018 report and Dr. Kruppenbacher’s January 7, 2019 report,

 

4 L.C., Docket No. 19-1301 (issued January 29, 2020); J.H., Docket No. 18-1637 (issued January 29, 2020); 

James E. Chadden, Sr., 40 ECAB 312 (1988).

5 P.A., Docket No. 18-0559 (issued January 29, 2020); K.M., Docket No. 15-1660 (issued September 16, 2016); 

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

6 T.H., Docket No. 19-0599 (issued January 28, 2020); K.L., Docket No. 18-1029 (issued January 9, 2019); John J. 

Carlone, 41 ECAB 354 (1989).

7 S.S., Docket No. 19-0688 (issued January 24, 2020); A.M., Docket No. 18-1748 (issued April 24, 2019); Robert G. 

Morris, 48 ECAB 238 (1996).

8 T.L., Docket No. 18-0778 (issued January 22, 2020); Y.S., Docket No. 18-0366 (issued January 22, 2020); 

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

9 See G.L., Docket No. 18-1057 (issued April 14, 2020); J.M., Docket No. 18-0853 (issued March 9, 2020); L.B., 

Docket No. 18-0533 (issued August 27, 2018).
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lack probative value on the issue of causal relationship and therefore is insufficient to establish 

appellant’s claim.

In his May 14, 2019 medical report, Dr. Kruppenbacher noted that appellant injured her 

right shoulder after tripping over packages at work on November 30, 2018. He diagnosed cervical 

radiculopathy, cervicalgia, and numbness. Dr. Kruppenbacher responded “yes” to whether he 

believed that the accepted November 30, 2018 employment incident was the competent medical 

cause of appellant’s injury, and that her history of the injury was consistent with his objective 

findings. While his medical opinion is generally supportive of causal relationship, he did not offer 

medical rationale sufficient to explain how and why he believes that the accepted November 30, 

2018 employment incident could have resulted in or contributed to the diagnosed condition. 

Moreover, the Board has held that a physician’s opinion on causal relationship which consists of 

responding “yes” to a form question, without explanation or rationale, is of diminished probative 

value and is insufficient to establish a claim.10 The Board also notes that Dr. Kruppenbacher 

indicated that appellant had no previous history of symptoms prior to the November 30, 2018 

employment incident, further suggesting that the accepted employment incident caused her 

diagnosed conditions because she was not symptomatic until after the fall. The Board has held 

that an opinion finding causal relationship because an employee was asymptomatic before the 

injury, but symptomatic after it is insufficient, without supporting medical rationale, to establish 

causal relationship.11 As Dr. Kruppenbacher did not provide a reasoned explanation of how 

tripping and falling caused or contributed to appellant’s injury, his May 14, 2019 report is also of 

limited probative value, and therefore is insufficient to meet her burden of proof.12

Finally, the record also contains reports from a physician assistant and a nurse practitioner. 

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

and social workers are not considered “physician[s]” as defined under FECA.13 Consequently, 

their medical findings and/or opinions will not suffice for purposes of establishing entitlement to 

FECA benefits.14

As none of the medical evidence appellant submitted constitutes rationalized medical 

evidence sufficient to establish causal relationship between the accepted November 30, 2018 

 

10 See J.R., Docket No. 18-1679 (issued May 6, 2019); M.C., Docket No. 18-0361 (issued August 15, 2018); 

Calvin E. King, Jr., 51 ECAB 394 (2000); see also Frederick E. Howard, Jr., 41 ECAB 843 (1990).

11 See J.F., Docket No. 19-1694 (issued March 18, 2020); M.B., Docket No. 19-0840 (issued October 2, 2019);

C.C., Docket No. 17-1841 (issued December 6, 2018); John F. Glynn, 53 ECAB 562 (2002); Thomas Petrylak, 39 

ECAB 276, 281 (1987).

12 See A.P., Docket No. 19-0224 (issued July 11, 2019).

13 5 U.S.C. § 8101(2); 20 C.F.R. § 10.5(t).

14 Section 8101(2) of FECA provides that medical opinions can only be given by a qualified physician. This section 

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. H.K., Docket No. 19-0429 (issued 

September 18, 2019); K.W., 59 ECAB 271, 279 (2007); David P. Sawchuk, 57 ECAB 316, 320 n.11 (2006); see also 

S.L., Docket No. 19-0603 (issued January 28, 2020) (nurse practitioners are not considered physicians as defined 

under FECA). 
6

employment incident and her diagnosed conditions, the Board finds that she has not met her burden 

of proof.15

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 medical 

condition causally related to the accepted November 30, 2018 employment incident.16

ORDER

IT IS HEREBY ORDERED THAT the August 23, 2019 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: May 22, 2020

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

 

15 R.G., Docket No. 18-0792 (issued March 11, 2020).

16 The Board notes that the employing establishment issued a Form CA-16. A completed Form CA-16 authorization

may constitute a contract for payment of medical expenses to a medical facility or physician, when properly executed. 

The form creates a contractual obligation, which does not involve the employee directly, to pay for the cost of the 

examination or treatment regardless of the action taken on the claim. See 20 C.F.R. § 10.300(c); J.G., Docket No. 

17-1062 (issued February 13, 2018); Tracy P. Spillane, 54 ECAB 608 (2003).