United States Department of Labor

Employees’ Compensation Appeals Board

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D.V., Appellant

and

U.S. POSTAL SERVICE, PHILADELPHIA 

NETWORK DISTRIBUTION CENTER ANNEX, 

Philadelphia, PA, Employer

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Docket No. 19-1642

Issued: June 4, 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 July 30, 2019 appellant filed a timely appeal from a May 2, 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.2

 

1 5 U.S.C. § 8101 et seq.

2 The Board notes that following the May 2, 2019 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 evidence for 

the first time on appeal. Id. 
2

ISSUE

The issue is whether appellant met his burden of proof to establish that his right wrist 

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

FACTUAL HISTORY

On December 4, 2018 appellant, then a 21-year-old casual mail handler, filed a traumatic 

injury claim (Form CA-1) alleging that on November 29, 2018 he injured his right wrist when he 

lifted a box which slipped from his hand while in the performance of duty. On the reverse side of 

the claim form, the employing establishment indicated that appellant was injured in the 

performance of duty and had stopped work on December 4, 2018.

A note from Smitha Ghevarughese, a registered nurse, indicated that appellant was seen in 

the emergency room on December 4, 2018 and that he could not return to work until he was cleared 

by work health.

December 4, 2018 hospital discharge instructions indicated that appellant was seen by

Dr. Andrew Ogden, an osteopathic physician specializing in emergency medicine. Dr. Ogden 

diagnosed a wrist strain and prescribed pain medication. He instructed appellant to avoid lifting 

with his right arm and provided him with information about wrist splints and wrist sprains.

In a December 21, 2018 development letter, OWCP indicated that when appellant’s claim 

was received it appeared to be a minor injury that resulted in minimal or no lost time from work, 

and that based on these criteria and because the employing establishment did not controvert the 

continuation of pay or challenge the merits of the case, payment of a limited amount of medical 

expenses was administratively approved. The merits of the claim, however, had not been formally 

considered. OWCP advised appellant that the documentation received to date was insufficient to 

support his claim for FECA benefits. It explained that the evidence of record was insufficient to 

establish that he sustained an injury in the performance of duty, as alleged. OWCP advised 

appellant of the factual and medical evidence necessary to establish his claim and attached a 

questionnaire for his completion. It afforded him 30 days to submit the requested factual and 

medical evidence.

December 10, 2018 hospital discharge instructions indicated that appellant was treated in 

the emergency room by Dr. Christopher Komurek, an osteopathic physician specializing in 

emergency medicine. Dr. Komurek diagnosed wrist pain and instructed appellant to follow up 

with an orthopedist.

In response to the December 27, 2018 questionnaire, appellant recounted the circumstances 

surrounding his alleged November 29, 2019 injury, indicated that he had no similar disabilities or 

symptoms before his injury.

By decision dated January 22, 2019, OWCP denied appellant’s traumatic injury claim, 

finding that the evidence of record failed to establish a diagnosed condition in connection with the 

accepted November 29, 2018 employment incident. It concluded, therefore, that the requirements 

had not been met to establish an injury as defined by FECA.
3

On February 4, 2019 appellant requested reconsideration. In an accompanying letter, he

described the circumstances surrounding his injury.

A December 4, 2018 x-ray interpreted by Dr. Barry Siskind, a Board-certified radiologist, 

revealed normal results. Dr. Siskind indicated that appellant experienced pain and a work-related 

injury.

December 4, 2018 emergency room records by Dr. Ogden indicated that appellant 

presented with mild and achy right wrist pain. Dr. Ogden related that appellant had lifted a heavy 

box at work five days previously when his right hand turned incorrectly and became painful. He 

noted that he was still in pain and continued to lift heavy objects at work. Dr. Ogden denied any 

other injuries and indicated his right wrist pain was exacerbated upon palpation. A physical 

examination of appellant revealed tenderness upon palpation of the ulnar styloid, discomfort with 

forced ulnar deviation, and otherwise normal results. Appellant’s December 4, 2018 right wrist 

x-ray results were noted and Dr. Ogden diagnosed wrist strain, specifically with a strain of an 

unspecified muscle, fascia, and tendon in the wrist and hand level. Dr. Ogden recommended that 

appellant refrain from lifting with his right arm.

Additional December 10, 2018 emergency room records authored by Dr. Komurek 

indicated that appellant presented with mild right wrist pain and persistent pain with range of 

motion in his wrist. Dr. Komurek noted that appellant had experienced constant wrist pain since 

his December 4, 2018 injury. He conducted a physical examination which revealed normal results. 

Dr. Komurek replaced appellant’s splint, recommended following up with an orthopedist, and 

diagnosed appellant with wrist sprain.

By decision dated May 2, 2019, OWCP modified its January 22, 2019 decision, finding 

that the evidence of record established a diagnosis in connection with the accepted November 29, 

2018 employment incident. However, it continued to deny appellant’s claim, finding that the 

evidence of record failed to establish a causal relationship between his diagnosed condition and 

his accepted November 29, 2018 employment incident. 

LEGAL PRECEDENT

An employee seeking benefits under FECA3 has the burden of establishing 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 of FECA,4that 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 

 

3 Supra note 1.

4

J.P., Docket No. 19-0129 (issued April 26, 2019); S.B., Docket No. 17-1779 (issued February 7, 2018); Joe D. 

Cameron, 41 ECAB 153 (1989). 
4

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 

An employee may establish that an injury occurred in the performance of duty as alleged, but fail 

to establish that the disability or specific condition for which compensation is being claimed is 

causally related to the injury.10

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.11 

ANALYSIS

The Board finds that appellant has not met his burden of proof to establish that his right 

wrist condition was causally related to the accepted November 29, 2018 employment incident.

December 4, 2018 emergency room records and hospital discharge notes by Dr. Ogden 

indicated that appellant presented with mild and achy right wrist pain and that five days prior he 

was lifting a heavy box at work when his right hand turned incorrectly and became painful. 

Dr. Ogden conducted a physical examination and diagnosed wrist strain, specifically with a strain 

of an unspecified muscle, fascia, and tendon in the wrist and hand level. However, he did not 

explain how appellant’s workplace incident caused his wrist strain. To be of probative medical 

value, a medical opinion must explain how physiologically the movements involved in the 

employment incident caused or contributed to the diagnosed condition.

12

 Dr. Ogden’s reports were 

therefore insufficient to establish appellant’s claim. 

 

5

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 R.R., Docket No. 19-0048 (issued April 25, 2019); L.M., Docket No. 13-1402 (issued February 7, 2014); 

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

7 E.M., Docket No. 18-1599 (issued March 7, 2019); T.H., 59 ECAB 388, 393-94 (2008). 

8 L.T., Docket No. 18-1603 (issued February 21, 2019); Elaine Pendleton, 40 ECAB 1143 (1989).

9 B.M., Docket No. 17-0796 (issued July 5, 2018); John J. Carlone, 41 ECAB 354 (1989).

10 J.P., supra note 4; L.T., supra note 8; Shirley A. Temple, 48 ECAB 404, 407 (1997).

11 Dennis M. Mascarenas, 49 ECAB 215 (1997).

12 See A.W., Docket No. 19-0327 (issued July 19, 2019). 
5

Dr. Komurek’s December 10, 2018 emergency room records indicated that appellant 

presented with mild right wrist pain and he diagnosed wrist sprain. He noted that appellant 

experienced constant wrist pain since his December 4, 2018 injury, and that appellant indicated he 

had persistent pain with range of motion in his wrist. However, Dr. Komurek did not provide his 

own opinion which addressed the cause of the diagnosed condition. Medical evidence which 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

OWCP also received December 4, 2018 records from Ms. Ghevarughese. Certain 

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

and social workers are not considered “physician[s]” as defined under FECA.14 Consequently, 

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

FECA benefits.15

Appellant also submitted a December 4, 2018 right wrist x-ray. The Board has explained 

that diagnostic studies standing alone lack probative value as they do not address whether the 

employment incident caused any of the diagnosed conditions.16

The Board therefore finds that the record lacks medical evidence establishing a causal 

relationship between appellant’s right wrist condition and the accepted November 29, 2018

employment incident. Thus, appellant has not met his 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 his burden of proof to establish that his right 

wrist condition was causally related to the accepted November 29, 2018 employment incident.

 

13 A.P., Docket No. 18-1690 (issued December 12, 2019); J.H., Docket No. 19-0383 (issued October 1, 2019); L.B.,

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

14 5 U.S.C. § 8101(2); 20 C.F.R. § 10.5(t).

15 Section 8101(2) of FECA 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); 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); R.L., Docket No. 19-0440 (issued July 8, 2019) (nurse practitioners are not considered physicians under 

FECA); K.W., 59 ECAB 271, 279 (2007); H.A., Docket No. 18-1253 (issued April 23, 2020) (a nurse practitioner is 

not considered a physician under FECA).

16 N.B., Docket No. 19-0221 (issued July 15, 2019). 
6

ORDER

IT IS HEREBY ORDERED THAT the May 2, 2019 decision of the Office of Workers’

Compensation Programs is affirmed. 

Issued: June 4, 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