United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

L.A., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Denver, CO, Employer

__________________________________________

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Docket No. 19-0820

Issued: December 6, 2019

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

JANICE B. ASKIN, Judge

ALEC J. KOROMILAS, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On March 4, 2019 appellant filed a timely appeal from a January 2, 2019 merit decision 

and a February 5, 2019 nonmerit 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

ISSUES

The issues are: (1) whether appellant has met her burden of proof to establish a right upper 

extremity condition causally related to the accepted factors of her federal employment; and 

 

1 5 U.S.C. § 8101 et seq.

2 The Board notes that, following the January 2, 2019 decision, OWCP and the Board on appeal 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

(2) whether OWCP properly denied appellant’s request for reconsideration of the merits of her

claim pursuant to 5 U.S.C. § 8128(a).

FACTUAL HISTORY

On September 29, 2018 appellant, then a 48-year-old mail handler assistant, filed an 

occupational disease claim (Form CA-2) alleging that she sustained an injury to her right arm while 

in the performance of duty. She indicated that she first became aware of her condition on 

August 15, 2018 and first realized it was caused or aggravated by factors of her federal 

employment on August 16, 2018. Appellant explained that she delayed reporting her condition 

because she thought she would get better. She did not stop work. 

On September 26, 2018 Dr. Darla Draper, Board-certified in family medicine examined 

appellant and noted her employment duties that required her to lift, pull and push cages filled with 

heavy products, as well as operate machinery. She reported appellant feeling pain in her right 

shoulder and lateral elbow, and, had pain with gripping and writing with her right hand. Dr. Draper 

diagnosed appellant with lateral epicondylitis of the right elbow, pain of the right hand, a right 

shoulder sprain and a thoracic myofascial strain. She opined that appellant’s injuries were work 

related and recommended that she wear a sling during six hours of her workday and prohibited the

use of her right upper extremity. Dr. Draper also recommended that appellant began physical 

therapy to treat her condition.

On September 28, 2018 appellant was seen by Dr. Jennifer Pula, Board-certified in internal 

medicine. Dr. Pula recounted that appellant believed her condition began when she moved from 

the night shift to the day shift, which required more lifting. Dr. Pula acknowledged appellant’s 

lateral epicondylitis of her right elbow and the sprain of her right shoulder, noted that her healing 

was in its beginning stages and maintained her previous work restrictions. The same day, appellant 

was seen by Diane Kiel, an occupational therapist. Ms. Kiel provided that appellant had reached

35 percent of her recovery goal.

On October 5, 2018 Dr. Pula updated her work restrictions based on her therapy progress. 

On October 19, 2019 appellant was seen by Jordan Maas, a physician assistant, for a 

follow-up appointment. Ms. Maas acknowledged appellant’s lateral epicondylitis of her right 

elbow and noted improvements with therapy. She opined that appellant’s description of her work 

duties did not seem to correlate with the criteria for epicondylitis. As a result, Ms. Maas updated 

appellant’s work restrictions and recommended that a job-site analysis be conducted in order to 

pinpoint the cause of appellant’s injury.

In a development letter dated October 24, 2018, OWCP notified appellant of the 

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

her claim and afforded her 30 days to submit the necessary evidence.

In response, appellant submitted an October 31, 2018 statement, wherein she noted that her 

primary work duties required her to work on a High-Speed Tray Sorter (HSTS). She explained

that the average loaded HSTS weighs around 17.5 pounds, but could weigh up to 30 pounds and 

sorts anywhere from 800 to 1200 letter trays per hour. She indicated that working with the HSTS 
3

required a lot of repetitive motion in moving letter trays, working the feed-belt and de-sleeving the 

letter trays. Appellant also indicated that she was required to lift sacks filled with mail, transport 

equipment and dump sacks filled with priority and first-class mail. She stated that she works the 

HSTS an average of 40 hours per week and performs the other duties for the remainder of her fiveday workweek, including overtime hours. Appellant further noted that because of the hours she 

works, she did not have any other outside activities that she believed contributed to her injuries. 

On November 2, 2018 appellant was seen by Cheryl Liedtke, a physician assistant, for a 

reevaluation of her injury. Ms. Liedtke acknowledged appellant’s lateral epicondylitis of her right 

elbow and noted that appellant was experiencing more pain in her right shoulder and back due to 

her use of a scanner as a part of her restricted work duties. She also ordered a work site evaluation 

after noting that an evaluation had not yet been conducted after Mr. Maas’ earlier recommendation. 

Ms. Liedtke recommended that appellant complete her therapy and return for a follow up after the 

work-site evaluation. 

On November 8, 2018 appellant was seen by Dr. Scott Richardson, Board-certified in 

emergency medicine. Dr. Richardson’s report referenced appellant’s lateral epicondylitis of her 

right elbow and her right shoulder sprain. Appellant also informed Dr. Richardson that she was 

experiencing constant pain in her right elbow and declined to undergo massage therapy. 

Dr. Richardson opined that appellant’s condition was roughly 50 percent healed. He 

recommended that appellant continue her physical therapy as scheduled and instructed that she

perform no lifting, pushing or pulling over five pounds.

In a November 13, 2018 medical report, Dr. Craig Davis, a Board-certified orthopedic 

surgeon, noted that appellant’s arm had good range of motion, but she experienced pain at the 

extremes. He opined that her treatment was reasonable and appropriate and administered a steroid 

injection to the tender spot just posterior to her medial epicondyle. Dr. Davis further recommended 

that appellant not use her right hand for three days and afterwards return to work under the work 

restrictions recommended by her occupational provider.

On November 30, 2018 Dr. Richardson modified appellant’s work restrictions to allow her 

to lift, push and pull up to 10 pounds with her right arm.

In a December 3, 2018 note, Dr. Pula reported that appellant informed her that she kept 

getting sent home from work early due to her work restrictions preventing her from lifting. 

Appellant demonstrated that she could lift 20 pounds in her therapy session and sought to have her 

work restrictions modified to reflect her progress. Dr. Pula’s updated her work restrictions to allow 

her to lift, push and pull up to 20 pounds for eight hours a day.

On December 17, 2018 appellant was seen by Dr. Nancy Strain, Board-certified in family 

medicine, who assessed lateral epicondylitis of the right elbow, right shoulder sprain and thoracic 

myofascial sprain. Appellant informed Dr. Strain that she was doing fine with her 20-pound work 

restriction and that she had begun to work more. Dr. Strain maintained appellant’s work 

restrictions and therapy treatment schedule.

Appellant also submitted therapy notes dated October 8 to December 20, 2018 from Kyle 

Ahlenstorf, an occupational therapist documenting her physical therapy sessions.
4

By decision dated January 2, 2019, OWCP denied appellant’s occupational disease claim, 

finding that the evidence submitted was insufficient to establish that her medical condition was 

causally related to the accepted factors of her federal employment.

Appellant resubmitted the medical reports from Drs. Draper, Pula, Richardson, and Davis, 

as well as Ms. Liedtke’s report, which were previously of record. She also resubmitted therapy 

notes from Ms. Kiel and Mr. Ahlenstorf. 

On January 28, 2019 appellant requested reconsideration of OWCP’s January 2, 2019 

decision. In an attached statement, she explained that she did not understand what information she 

was required to provide in order to establish her claim.

By decision dated February 5, 2019, OWCP denied appellant’s request for reconsideration

of the merits of her claim.

LEGAL PRECEDENT -- ISSUE 1

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

OWCP’s regulations define the term “occupational disease or illness” as a condition 

“produced by the work environment over a period longer than a single workday or shift.”

6

 To 

establish that an injury was sustained in the performance of duty in an occupational disease claim, 

a claimant must submit the following: (1) a factual statement identifying employment factors 

alleged to have caused or contributed to the presence or occurrence of the disease or condition; 

(2) medical evidence establishing the presence or existence of the disease or condition for which 

compensation is claimed; and (3) medical evidence establishing that the employment factors 

identified by the claimant were the proximate cause of the condition for which compensation is 

claimed or, stated differently, medical evidence establishing that the diagnosed condition is 

causally related to the employment factors identified by the claimant. 

 

3 Supra note 1.

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., id.; M.E., id.; K.B., Docket No. 17-1997 (issued July 27, 2018).

6 20 C.F.R. § 10.5(q).
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Causal Relationship is a medical question that requires rationalized medical opinion 

evidence to resolve the issue.7 A physician’s opinion on whether there is causal relationship 

between the diagnosed condition and the implicated employment factors must be based on a 

complete factual and medical background.8 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.9

ANALYSIS -- ISSUE 1

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

extremity condition causally related to the accepted factors of her federal employment.

In her September 27, 2018 report, Dr. Draper diagnosed pain of the right hand, lateral 

epicondylitis of the right elbow, a right shoulder sprain and a thoracic myofascial strain. She noted 

appellant’s description of her work duties and opined that her condition was the result of a workrelated injury. While Dr. Draper provided an affirmative opinion on causal relationship, her 

opinion is insufficiently rationalized as it is largely based on appellant’s belief as to what caused 

her injuries, rather than by an independent analysis of the cause of the condition. Further, she did 

not explain the process by which appellant’s employment factors caused or contributed to the 

diagnosed conditions.10 A mere conclusion without the necessary rationale explaining how and 

why the physician believes that a claimant’s accepted incident resulted in the diagnosed condition 

is insufficient to meet appellant’s burden of proof.11 Accordingly, the Board finds that

Dr. Draper’s medical report is of limited probative value on this issue of causal relationship.

In her September 28, October 5, and December 3, 2018 medical reports, Dr. Pula

diagnosed epicondylitis of the right elbow and a right elbow sprain, however, she did not offer her 

own opinion as to the cause of appellant’s 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.12 A medical opinion must provide an explanation as to 

how the specific employment factors physiologically caused or aggravated the diagnosed 

conditions.13 Thus, Dr. Pula’s medical reports are of no probative value on the issue of causal 

relationship.

 

7 K.V., supra note 4; A.D., 58 ECAB 149 (2006); D. Wayne Avila, 57 ECAB 642 (2006).

8 K.V., supra note 4; Michael S. Mina, 57 ECAB 379 (2006); Victor J. Woodhams, 41 ECAB 345, 352 (1989).

9

I.J., 59 ECAB 408 (2008); Victor J. Woodhams, id.

10 See D.L., Docket No. 15-0866 (issued November 23, 2015); J.S., Docket No. 14-0818 (issued August 7, 2014).

11 D.L., id.; G.M., Docket No. 14-2057 (issued May 12, 2015).

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

13 See V.T., Docket No. 18-0881 (issued November 19, 2018).
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Similarly, Dr. Richardson’s November 8 and 30, 2018 medical reports did not offer an 

opinion on the cause of appellant’s conditions. Also, Drs. Davis and Strain did not offer an opinion 

on causal relationship between appellant’s right upper extremity conditions and the accepted 

factors of her employment. Accordingly, these medical opinions are of no probative value on the 

issue of causal relationship.

14

Appellant also submitted multiple medical reports authored by physician assistants and her 

occupational therapist. These reports do not constitute competent medical evidence because 

physician assistants and occupational therapists are not considered a “physician” as defined under 

FECA.15 Certain healthcare providers such as physician assistants, nurse practitioners, 

occupational therapists, and social workers are not considered “physician[s]” as defined under 

FECA.16 Consequently, their medical findings and/or opinions will not suffice for purposes of 

establishing entitlement to compensation benefits.17 As such, these reports are of no probative 

value and are found to be insufficient to establish appellant’s claim.18

The fact that a condition manifests itself during a period of employment is insufficient to 

establish causal relationship.19 Temporal relationship alone will not suffice. Entitlement to FECA 

benefits may not be based on surmise, conjecture, speculation, or on the employee’s own belief of 

a causal relationship.20 As the record lacks rationalized medical evidence establishing causal 

relationship between the accepted employment factors and appellant’s claimed conditions, 

appellant has not met her burden of proof. 

Appellant may submit new evidence 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.

 

14 Supra note 12.

15 5 U.S.C. § 8101(2); Sean O Connell, 56 ECAB 195 (2004) (physician’s assistants); see R.S., Docket No. 16-1303 

(issued December 2, 2016) (occupational therapists are not considered physicians as defined under FECA); see also 

Gloria J. McPherson, 51 ECAB 441 (2000); 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).

16 5 U.S.C. § 8101(2); 20 C.F.R. § 10.5(t).

17 K.W., 59 ECAB 271, 279 (2007); David P. Sawchuk, 57 ECAB 316, 320 n.11 (2006). A report from a physician 

assistant or physical therapist will be considered medical evidence if countersigned by a qualified physician. Federal 

(FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.805.3a(1) (January 2013).

18 See K.C., Docket No. 16-1181 (issued July 26, 2017).

19 M.H., Docket No. 18-1737 (issued March 13, 2019); Daniel O. Vasquez, 57 ECAB 559 (2006).

20 S.G., Docket No. 18-1373 (issued February 12, 2019); D.D., 57 ECAB 734 (2006).
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LEGAL PRECEDENT -- ISSUE 2

Section 8128(a) of FECA does not entitle a claimant to review of an OWCP decision as a 

matter of right.21 OWCP has discretionary authority in this regard and has imposed certain 

limitations in exercising its authority.22 One such limitation is that the request for reconsideration 

must be received by OWCP within one year of the date of the decision for which review is sought.23 

A timely application for reconsideration, including all supporting documents, must set forth 

arguments and contain evidence that either: (1) shows that OWCP erroneously applied or 

interpreted a specific point of law; (2) advances a relevant legal argument not previously 

considered by OWCP; or (3) constitutes relevant and pertinent new evidence not previously 

considered by OWCP.24 When a timely application for reconsideration does not meet at least one 

of the above-noted requirements, OWCP will deny the request for reconsideration, without 

reopening the case for a review on the merits.25

ANALYSIS -- ISSUE 2

The Board finds that OWCP properly denied appellant’s request for reconsideration of the 

merits of her claim pursuant to 5 U.S.C. § 8128(a). 

Appellant’s request for reconsideration did not establish that OWCP erroneously applied 

or interpreted a specific point of law, or advance a new and relevant legal argument not previously 

considered by OWCP. In her statement accompanying her request for reconsideration, appellant 

argued that she did not understand what evidence was necessary in order to support her claim. 

Accordingly, she is not entitled to a review of the merits of her claim based on the first and second 

above-noted requirements under section 10.606(b)(3). 

In support of her request for reconsideration, appellant resubmitted copies of the medical 

reports of Drs. Draper, Pula, Richardson, and Davis, as well as reports from Ms. Liedtke, Ms. Kiel, 

and Mr. Ahlenstorf, which were already of record and previously considered by OWCP. The 

Board has held that the submission of evidence which repeats or duplicates evidence already in 

the case record does not constitute a basis for reopening a case.26 

 

21 This section provides in pertinent part: [t]he Secretary of Labor may review an award for or against payment of 

compensation at any time on his own motion or on application. 5 U.S.C. § 8128(a).

22 20 C.F.R. § 10.607.

23 Id. at § 10.607(a). For merit decisions issued on or after August 29, 2011, a request for reconsideration must be 

received by OWCP within one year of OWCP’s decision for which review is sought. Federal (FECA) Procedure 

Manual, Part 2 -- Claims, Reconsiderations, Chapter 2.1602.4 (February 2016). Timeliness is determined by the 

document receipt date of the request for reconsideration as indicated by the received date in the integrated Federal 

Employees’ Compensation System (iFECS). Id. at Chapter 2.1602.4b.

24 Id. at § 10.606(b)(3).

25 Id.

26 See L.R., Docket No. 18-0400 (issued August 24, 2018).
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A claimant may be entitled to a merit review by submitting relevant and pertinent new 

evidence, but the Board finds that appellant did not submit any such evidence in this case.27 The 

various reports submitted by appellant did not provide any relevant and pertinent new evidence or 

any opinion regarding why appellant’s employment factors should be accepted as causally related 

to her diagnosed conditions. Therefore, OWCP was not required to reopen appellant’s claim for 

reconsideration of the merits in accordance with the third above-noted requirement under section 

10.606(b)(3).28 Pursuant to 20 C.F.R. § 10.608, OWCP properly denied merit review.29

On appeal appellant submitted new medical evidence she contends would meet her burden 

of proof to establish causal relationship. However, as previously noted, the Board is precluded 

from reviewing evidence for the first time on appeal.30

CONCLUSION

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

extremity condition causally related to the accepted factors of her federal employment. The Board 

further finds that OWCP properly denied her request for reconsideration of the merits of her claim

pursuant to 5 U.S.C. § 8128(a).

 

27 20 C.F.R. § 10.606(b)(3); see also M.S., Docket No. 18-1041 (issued October 25, 2018); C.N., Docket No. 08-

1569 (issued December 9, 2008).

28 C.R., Docket No. 18-1569 (issued March 7, 2019); R.L., Docket No. 18-0175 (issued September 5, 2018).

29 C.C., Docket No. 18-0316 (issued March 14, 2019); M.E., 58 ECAB 694 (2007); Susan A. Filkins, 57 ECAB 630 

(2006) (when an application for reconsideration does not meet at least one of the three requirements enumerated under 

section 10.606(b), OWCP will deny the application for reconsideration without reopening the case for a review on the 

merits).

30 Supra note 2.
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ORDER

IT IS HEREBY ORDERED THAT the February 5 and January 2, 2019 decisions of the 

Office of Workers’ Compensation Programs are affirmed.

Issued: December 6, 2019

Washington, DC

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board