United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

G.G., Appellant

and

U.S. POSTAL SERVICE, MERRIFIELD 

PROCESSING & DISTRIBUTION CENTER, 

Merrifield, VA, Employer

__________________________________________

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Docket No. 21-0736

Issued: December 20, 2021

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

JANICE B. ASKIN, Judge

PATRICIA H. FITZGERALD, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On April 20, 2021 appellant filed a timely appeal from a March 23, 2021 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 March 23, 2021decision, 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 lower back 

condition causally related to the accepted January 29, 2021 employment incident.

FACTUAL HISTORY

On February 11, 2021 appellant, then a 48-year-old mail processing clerk, filed a traumatic 

injury claim (Form CA-1) alleging that on January 29, 2021 she injured her lower back when 

lifting trays while in the performance of duty. On the reverse side of the claim form, the employing 

establishment acknowledged that she was injured in the performance of duty. Appellant stopped 

work on January 29, 2021.

In a February 9, 2021 medical report, Dr. Nori Buising, Board-certified in family medicine, 

indicated that appellant injured her back while moving parcels. She diagnosed sciatica of the left 

side associated with a disorder of the lumbosacral spine and referred appellant to orthopedic 

surgery for further evaluation. In a medical note of even date, Dr. Buising opined that appellant 

should remain off work until February 13, 2021 and only perform desk work upon her return.

In a February 9, 2021 duty status report (Form CA-17), Dr. Buising noted that appellant 

experienced pain in her back when lifting letter trays on January 29, 2021 and submitted work 

restrictions for her to follow.

On February 11, 2021 the employing establishment controverted appellant’s claim,

asserting that she submitted medical evidence that suggested that she had a preexisting condition 

and that there were inconsistencies in her description of how her injury occurred.

In a development letter dated February 12, 2021, OWCP informed appellant of the 

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

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

days to provide the necessary information.

In a February 15, 2021 medical report,Lisa J. Siddall, a nurse practitioner, ordered physical 

therapy to treat appellant’s diagnosed degenerative lumbar disc and lumbar radicular pain. In a 

medical note of even date, she recommended that appellant only perform light-duty work.

On March 1, 2021 the employing establishment submitted a copy of an offer of modified 

assignment (limited duty), consisting of manually casing letters for six hours per day, sitting, 

simple grasping, and no lifting over three pounds.

In a March 15, 2021 medical report, Ms. Siddall evaluated appellant for lumbar pain that 

began on January 29, 2021. She diagnosed degenerative lumbar disc and lumbar radicular pain

and referred her to physical therapy. In a Form CA-17 of even date, Ms. Siddall reiterated her 

diagnoses and also provided work restrictions for appellant.

By decision dated March 23, 2021, OWCP denied appellant’s traumatic injury claim, 

finding that the medical evidence of record was insufficient to establish a diagnosed medical 

condition causally related to the accepted January 29, 2021 employment incident.
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LEGAL PRECEDENT

An employee seeking benefits under FECA 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,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 if an employee has sustained a traumatic injury in the performance of duty, 

OWCP begins with an analysis of whether fact of injury has been established. 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.6 The second component is whether the employment incident caused a personal injury.7

Causal relationship is a medical question that requires rationalized medical opinion 

evidence to resolve the issue.8 A physician’s opinion on whether there is causal relationship 

between the diagnosed condition and the implicated employment factor(s) must be based on a 

complete factual and medical background.9 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(s).10

ANALYSIS

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

condition causally related to the accepted January 29, 2021 employment incident.

Dr. Buising, in her February 9, 2021 medical report, indicated that appellant injured her 

back while moving parcels and diagnosed sciatica of the left side associated with a disorder of the 

lumbar spine. However, she failed to explain, with rationale, how the accepted employment 

3

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

153 (1989).

4 L.S., Docket No. 19-1769 (issued July 10, 2020); Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000).

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

DeloresC. Ellyett, 41 ECAB 992 (1990).

6 B.P., Docket No. 16-1549 (issued January 18, 2017); Elaine Pendleton, 40 ECAB 1143 (1989).

7 M.H., Docket No. 18-1737 (issued March 13, 2019); John J. Carlone, 41 ECAB 354 (1989).

8 T.H., 59 ECAB 388, 393 (2008); Robert G. Morris, 48 ECAB 238 (1996).

9 M.V., Docket No. 18-0884 (issued December 28, 2018).

10 B.C., Docket No. 20-0221 (issued July 10, 2020); Leslie C. Moore, 52 ECAB 132 (2000).
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incident either caused or contributed to her diagnosed lumbar condition. The Board has held that 

a medical opinion should offer a medically-sound and rationalized explanation by the physician of 

how the specific employment incident physiologically caused or aggravated the diagnosed 

conditions.11 For thisreason, Dr. Buising’s February 9, 2021 medical report is insufficient to meet 

appellant’s burden of proof.

In her February 9, 2021 Form CA-17, Dr. Buising noted that appellant experienced pain in 

her back when lifting letter trays on January 29, 2021. The Board has held, however, that pain is 

a symptom and not a compensable medical diagnosis.12 Moreover, Dr. Buising did not offer an 

opinion on causal relationship. 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.13 The Form CA-17 is, therefore, insufficient to establish appellant’s claim.

The remaining medical evidence consists of medical reports and notes signed by a nurse 

practitioner. However, certain healthcare providers such as physician assistants, nurse 

practitioners, and physical therapists are not considered physicians as defined under FECA. 14 

Consequently, this evidence will not suffice for purposes of establishing entitlement to FECA 

benefits.15

As the medical evidence of record is insufficient to establish causal relationship between a

lumbar condition and the accepted January 29, 2021 employment incident, the Board finds that 

she has not met her burden of proof.

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 lumbar 

condition causally related to the accepted January 29, 2021 employment incident.

11 J.D., Docket No. 19-1953 (issued January11, 2021); see K.W., Docket No. 19-1906 (issued April1, 2020).

12 See S.L., Docket No. 19-1536 (issued June26, 2020); D.Y., Docket No. 20-0112 (issued June 25, 2020).

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

14 Section 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,” 

5 U.S.C. § 8101(2); 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); M.F., Docket No. 19-1573 (issued March 16, 2020); N.B., Docket 

No. 19-0221 (issued July 15, 2019); DavidP. 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).

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

FECA).
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ORDER

IT IS HEREBY ORDERED THAT the March 23, 2021 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: December 20, 2021

Washington, DC

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board