United States Department of Labor

Employees’ Compensation Appeals Board

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K.M., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE,

Ithaca, NY, Employer

__________________________________________

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Docket No. 21-0016

Issued: April 21, 2021

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

PATRICIA H. FITZGERALD, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On October 7, 2020 appellant filed a timely appeal from a September 4, 2020 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 right foot/toe 

condition causally related to the accepted June 20, 2020 employment incident. 

FACTUAL HISTORY

On June 29, 2020 appellant, then a 31-year-old postal support employee, filed a traumatic 

injury claim (Form CA-1) alleging that on June 20, 2020, as she was opening up a pallet, a heavy 

 

1 5 U.S.C. § 8101 et seq.
2

package fell and hit her foot/toe. On the reverse side of the claim form her supervisor indicated 

that appellant was injured in the performance of duty. Appellant stopped work on June 20, 2020.

In support of her claim, appellant submitted a report dated June 20, 2020 from Jessica 

Price, a nurse practitioner. Ms. Price indicated that appellant related that a heavy box fell onto her 

right foot on June 20, 2020 and caused pain, swelling, and bruising to occur. She also noted that 

appellant started to develop some ecchymosis to the lateral aspect of the foot, the location of the 

pain, and that appellant denied any previous injury to her foot. Appellant was diagnosed with a

nondisplaced unspecified fracture to her right lesser toe caused by a falling object.

Appellant submitted a form report dated June 20, 2020 completed by Ms. Price. Ms. Price

indicated that a heavy box fell on appellant’s right foot and she diagnosed a lateral fracture of the 

right toe, the fifth digit. She indicated that appellant should remain off work until June 24, 2020

and thereafter returned to sedentary work.

Appellant submitted an x-ray imaging report dated June 20, 2020 from Dr. Corey J. Weiner 

a Board-certified diagnostic radiology specialist. Dr. Weiner noted that appellant’s right midfoot 

and hindfoot regions were intact. He diagnosed a subtle acute nondisplaced fracture at the base of 

the fused distal phalanx in the fifth digit of the right foot.

In a letter dated July 6, 2020, Susan Carlisle, a physician assistant, related that appellant 

was seen in the Guthrie clinic on July 6, 2020. She noted that appellant could return to work on 

July 8, 2020 for eight hours a day and that appellant must wear a supportive sneaker until further 

notice.

In a development letter dated July 30, 2020, OWCP advised appellant that additional 

factual and medical evidence was necessary to establish her claim. It requested that appellant 

provide a statement indicating which foot/toe was injured. OWCP also requested that appellant 

submit a narrative medical report from her attending physician, which includes the physician’s 

opinion supported by a medical explanation as to how the reported employment incident caused 

or aggravated the claimed injury. It afforded appellant 30 days to submit the necessary evidence.

In response, appellant resubmitted documents dated June 20, 2020 from Ms. Price and

Dr. Weiner.

OWCP also received a report dated August 19, 2020 from Ms. Carlisle, who indicated that 

appellant returned for a follow-up visit for fracture of her right fifth toe. Ms. Carlisle related that 

appellant had no swelling and a full range of motion with no pain. She concluded that appellant 

could return to work with no restrictions.

By decision dated September 4, 2020, OWCP accepted that the June 20, 2020 employment 

incident occurred, as alleged, but denied appellant’s claim as causal relationship was not 

established between a diagnosed medical condition and the accepted employment incident. It 

concluded, therefore, that the requirements had not been met to establish an injury as defined by 

FECA.
3

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 FECA, that the claim was timely filed within the applicable time 

limitation period of FECA,3that 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.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 must first be determined whether a 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. 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 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

 

2

Id.

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

Cameron, 41 ECAB 153 (1989).

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).
4

ANALYSIS

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

condition causally related to the accepted June 20, 2020 employment incident. 

Appellant submitted an x-ray report dated June 20, 2020 from Dr. Weiner in which he 

diagnosed her with a subtle acute nondisplaced fracture at the base of the fused distal phalanx in 

the fifth digit of the right foot. The Board has held that diagnostic tests, standing alone, lack 

probative value on the issue of causal relationship as they do not address the relationship between 

the accepted employment factors and a diagnosed condition.9 For this reason, Dr. Weiner’s report 

is insufficient to meet appellant’s burden of proof.

Appellant submitted two reports dated June 20, 2020 in which Ms. Price, a nurse 

practitioner, indicated that appellant had related that a heavy box fell onto her right foot on

June 20, 2020. Ms. Price noted that appellant was diagnosed with a nondisplaced unspecified 

fracture to her right lesser toe caused by a falling object. Certain healthcare providers such as 

physician assistants, nurse practitioners, and physical therapists are not considered physicians as 

defined under FECA.10 Consequently, Ms. Price’s reports will not suffice for purposes of 

establishing entitlement to FECA benefits.11

Appellant submitted a letter dated July 6, 2020 in which Ms. Carlisle, a physician assistant, 

related that appellant could return to work on July 8, 2020 for eight hours a day. She also submitted 

a report dated August 19, 2020 from Ms. Carlisle, which indicated that appellant returned for a 

follow-up visit for fracture of her right fifth toe. However, as noted above, physician assistants

are not considered physicians as defined under FECA.12 Consequently, Ms. Carlisle’s letter and 

report will not suffice for purposes of establishing entitlement to FECA benefits.13

As there is no medical evidence of record establishing that appellant’s diagnosed right toe 

fracture was causally related to the accepted employment incident, the Board finds that appellant 

has not met her burden of proof to establish a diagnosed medical condition causally related to the 

accepted June 20, 2020 employment incident. 

 

9 See W.M., Docket No. 19-1853 (issued May 13, 2020); L.F., Docket No. 19-1905 (issued April 10, 2020).

10 5 U.S.C. § 8101(2) provides that physician “includes surgeons, podiatrists, dentists, clinical psychologists, 

optometrists, chiropractors, and osteopathic practitioners within the scope of their practice as defined by State law,” 

20 C.F.R. § 10.5(t). See also Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 

2.805.3a(1) (January 2013); see also M.F., Docket No. 19-1573 (issued March 16, 2020); N.B., Docket No. 19-0221 

(issued July 15, 2019); 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).

11 See M.C., Docket No. 19-1074 (issued June 12, 2020) (nurse practitioners are not considered physicians under 

FECA).

12 Supra note 10. 

13 Supra note 11. 
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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 right foot/toe 

condition causally related to the June 2, 2020 employment incident. 

ORDER

IT IS HEREBY ORDERED THAT the September 4, 2020 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: April 21, 2021

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board