United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

V.B., Appellant

and

DEPARTMENT OF VETERANS AFFAIRS, 

VETERANS ADMINISTRATION MEDICAL 

CENTER, Baltimore, MD, Employer

__________________________________________

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Docket No. 19-0500

Issued: August 8, 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

PATRICIA H. FITZGERALD, Deputy Chief Judge

ALEC J. KOROMILAS, Alternate Judge

JURISDICTION

On January 8, 2019 appellant filed a timely appeal from a December 12, 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

 

1 5 U.S.C. § 8101 et seq.

2 The Board notes that following the December 12, 2018 decision, OWCP received additional evidence. However, 

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 

additional evidence for the first time on appeal. Id.
2

ISSUE

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

condition causally related to the accepted October 29, 2018 employment incident.

FACTUAL HISTORY

On November 1, 2018 appellant, then a 37-year-old food service worker, filed a traumatic 

injury claim (Form CA-1) alleging that, on October 29, 2018, she injured her right knee and back 

when she fell after her foot got stuck to a kitchen mat while in the performance of duty. On the 

reverse side of the claim form, the employing establishment indicated that appellant stopped work 

on the date of injury and returned to work the next day on October 30, 2018. 

In a report and accompanying letter dated October 29, 2018, Kevan Davenport, a physician 

assistant, noted that appellant sustained a muscle spasm and that she could return to work on 

October 30, 2018. 

In a development letter dated November 7, 2018, OWCP advised appellant that the 

evidence submitted was insufficient to establish her claim. It provided a questionnaire for her 

completion and requested additional factual and medical evidence to substantiate her claim. 

OWCP afforded appellant 30 days to submit the requested evidence. 

In a letter dated November 8, 2018, the employing establishment controverted appellant’s 

claim. It noted that a safety investigator examined the area she claimed to have fallen and did not 

find grease, or other sticky substance on the ground. The employing establishment also indicated 

that appellant had neither established a diagnosis, nor causal relationship, in relation to the alleged 

employment incident. 

In a supplementalstatement dated October 29, 2018, appellant explained that as she walked

passed the fryer on her way back to her station, the floor mat stuck to her shoe and she fell forward 

on the floor. She noted that she injured her right knee and back, and a coworker helped her off of 

the floor. 

In a letter dated November 14, 2018, Dr. Joyce Evans, Board-certified in family practice, 

indicated that she examined appellant on November 6, 2018, and indicated that she had a back 

injury. She related work restrictions to be in effect through November 16, 2018, including 

avoiding bending, no lifting over five pounds, and limited prolonged standing. 

In a subsequent letter dated November 20, 2018, Dr. Evans indicated that appellant had 

suffered a back injury, and recommended work restrictions including no bending or lifting. 

In a report dated December 7, 2018, Dr. Evans reviewed appellant’s history of injury. She 

indicated that she examined appellant regarding her October 29, 2018 injury on November 6 

and 20, 2018. Dr. Evans noted that appellant had x-rays completed of her lumbar spine and right 

knee on November 30, 2018, which revealed only minimal spondylosis of the back and some 

degenerative changes in the knee. She diagnosed back injury, right knee injury, and knee pain. 

Dr. Evans opined that appellant sustained injury due to a “fall at work” which caused back spasm 

and pain. 
3

By decision dated December 12, 2018, OWCP denied appellant’s claim finding that the 

evidence of record was insufficient to establish a diagnosis in connection with the accepted 

October 29, 2018 employment incident.

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,4and that 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 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 Fact of injury 

consists of two components that must be considered in conjunction with one another. The first 

component is whether the employee actually experienced the employment incident that allegedly 

occurred.8 The second component is whether the employment incident caused a personal injury.9

Rationalized medical opinion evidence is 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 incident.10 

Neither the mere fact that a disease or condition manifests itself during a period of employment, 

nor the belief that the disease or condition was caused or aggravated by employment factors or 

incidents is sufficient to establish causal relationship.11

 

3 Supra note 1.

4 S.C., Docket No. 18-1242 (issued March 13, 2019); S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59 

ECAB 178 (2007); Joe D. Cameron, 41 ECAB 153 (1989).

5 T.H., Docket No. 18-1736 (issued March 13, 2019); 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 T.E., Docket No. 18-1595 (issued March 13, 2019); 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 S.S., Docket No. 18-1488 (issued March 11, 2019); T.H., 59 ECAB 388, 393-94 (2008).

8 E.M., Docket No. 18-1599 (issued March 7, 2019); Elaine Pendleton, 40 ECAB 1143 (1989).

9 E.M., id.; John J. Carlone, 41 ECAB 354 (1989).

10 T.M., Docket No. 19-0380 (issued June 26, 2019); S.S., supra note 7.

11 T.M., id.; J.L., Docket No. 18-1804 (issued April 12, 2019).
4

ANALYSIS

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

medical condition causally related to the accepted October 29, 2018 employment incident.

Appellant submitted a report and letter dated October 29, 2018 from Mr. Davenport, a 

physician assistant. The Board has held that medical reports signed solely by a physician assistant 

are of no probative value as physician assistants are not considered physicians as defined under 

FECA and are therefore not competent to render a medical opinion.12 These reports are therefore

insufficient to establish the claim.

In her December 7, 2018 report, Dr. Evans reviewed appellant’s history of injury and 

diagnosed back injury, right knee injury, and knee pain. She also opined that appellant’s injuries 

were caused by a “fall at work.” A vague description of an “injury” fails to establish a firm medical 

diagnosis and provides no causal support for an injury.

13

 The Board also notes that pain and spasm 

are symptoms, not compensable medical diagnoses.14 While Dr. Evans related that appellant’s fall 

at work caused back spasm and pain, the Board has held that a medical report is of no probative 

value if it does not provide a firm diagnosis of a particular medical condition, or offer a specific 

opinion as to whether the accepted employment incident caused or aggravated the claimed 

conditions.

15

Appellant also submitted her own personal statement dated October 29, 2018, in which she 

related that she injured her knee and back when her foot got stuck to the floor mat and she fell 

forward. However, her own lay opinion is not relevant to the medical issue in this case, which can 

only be resolved through the submission of probative medical evidence from a physician

containing a medical diagnosis.

16

As the medical evidence of record is insufficient to establish a diagnosed medical condition 

causally related to the accepted October 29, 2018 employment incident, the Board finds that 

appellant has not met her burden of proof.

 

12 E.T., Docket No. 17-0265 (issued May 25, 2018) (physician assistants are not considered physicians under 

FECA); see David P. Sawchuk, 57 ECAB 316, 320 n.11 (2006) (health care providers 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).

13 See J.L., Docket No. 18-1804 (issued April 12, 2019). 

14 T.J., Docket No. 18-1500 (issued May 1, 2019) (the Board has held that pain and spasm are symptoms not medical 

diagnoses).

15 T.J., id.; see M.J., Docket No. 18-1114 (issued February 5, 2019).

16 D.N., Docket No. 19-0070 (issued May 10, 2019); see G.C., Docket No. 18-0506 (issued August 15, 2018).
5

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 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 diagnosed 

medical condition causally related to the accepted October 29, 2018 employment incident.

ORDER

IT IS HEREBY ORDERED THAT the December 12, 2018 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: August 8, 2019

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate Judge

Employees’ Compensation Appeals Board