United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

D.O., Appellant

and

DEPARTMENT OF HOMELAND SECURITY, 

CITIZENSHIP & IMMIGRATION SERVICES, 

Miami, FL, Employer

__________________________________________

)

)

)

)

)

)

)

)

)

Docket No. 20-0307

Issued: June 26, 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

PATRICIA H. FITZGERALD, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On November 25, 2019 appellant filed a timely appeal from a June 4, 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.

ISSUE

The issue is whether appellant has met her burden of proof to establish a left hip condition 

causally related to the accepted December 6, 2018 employment incident.

FACTUAL HISTORY

On December 18, 2018 appellant, then a 45-year-old immigration officer, filed a traumatic 

injury claim (Form CA-1) alleging that on December 6, 2018 she suffered a left hip fracture when 

entering her government vehicle while in the performance of duty. She noted that she felt a 

 

1 5 U.S.C. § 8101 et seq.
2

snap/pulling sensation in her left hip and felt excruciating pain immediately. On the reverse side 

of the claim form, the employing establishment acknowledged that appellant was injured in the 

performance of duty. Appellant stopped work on December 7, 2018. 

An after-visit summary, dated December 7, 2018, indicated that appellant saw Dr. Dalia 

McCoy, a Board-certified family practitioner, for left hip pain that day. 

A magnetic resonance imaging (MRI) scan of appellant’s left hip, dated December 14, 

2018, revealed a closed fracture of the left hip and a suspected bone lesion.

In a December 14, 2018 after-visit summary, Dr. Leonardo Oliveira, a Board-certified 

specialist in sports medicine, diagnosed left hip pain and a closed fracture of the left hip. 

In a December 18, 2018 witness statement, L.W., appellant’s coworker, noted that on 

December 6, 2018 while working together she saw appellant enter the driver side of her work 

vehicle. She indicated that appellant was in pain when she arrived at the office and was limping 

while attempting to walk. 

In a December 28, 2018 development letter, OWCP informed appellant that when her claim 

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

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

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

expenses was administratively approved. It explained that it had now reopened the claim for 

consideration because she had not returned to work in a full-time capacity. OWCP requested that 

appellant provide additional medical evidence in support of her claim, including a physician’s 

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

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

In a December 18, 2018 authorization for examination and/or treatment (Form CA-16), the 

employing establishing authorized appellant to seek medical care. In a December 28, 2018 

attending physician’s report, Part B of the Form CA-16, Dr. Oliveira reported that appellant felt a 

pop in her left hip after getting into a vehicle. He diagnosed tensor fascia lata syndrome and 

checked a box marked “Yes” indicating that the condition was caused or aggravated by the 

described employment activity. Dr. Oliveira advised that appellant could resume light-duty work 

on December 19, 2018.

In a December 28, 2018 duty status report (Form CA-17), Dr. Oliveira diagnosed left tensor 

fascia lata avulsion tear and checked a box marked “Yes” indicating that the condition 

corresponded to appellant entering her work vehicle after a site visit. He noted that she could 

return to work with restrictions on December 28, 2018. 

An after-visit summary, dated December 28, 2018, Dr. Oliveira indicated that he treated 

appellant for tensor fascia lata syndrome. He referred her for physical therapy treatment.

OWCP received physical therapy treatment notes dated January 10, 2019.

In a January 21, 2019 attending physician’s report (Form CA-20), Dr. Oliveira diagnosed 

tensor fascia lata syndrome and checked a box marked “Yes” to indicate that the condition was 
3

caused or aggravated by an employment activity. He noted that she was able to resume regular 

work on February 21, 2019. 

By decision dated January 30, 2019, OWCP denied appellant’s traumatic injury claim,

finding that the medical evidence of record was insufficient to establish causal relationship 

between her diagnosed conditions and the accepted December 6, 2018 employment incident.

X-rays of appellant’s pelvis and hips, dated December 7, 2018, revealed no significant 

abnormalities. 

In a December 14, 2018 report, Dr. Oliveira noted that appellant presented with left hip 

pain that had lasted for approximately one week. He related her history of injury of experiencing 

a snap in her hip as she was getting into her vehicle. Dr. Oliveira reviewed an MRI scan of 

appellant’s left hip and diagnosed left hip pain and a closed fracture of the left hip. 

An MRI scan of appellant’s left hip, dated December 15, 2018, revealed high-grade and 

suspected full-thickness tear/avulsion of the left tensor fascia tendon, possible left gluteus minimus 

and medius tendon strains, left-sided greater trochanteric bursitis, small tear of the anterior labrum 

of the left hip, and possible uterine adenomyosis.

In a December 28, 2018 report, Dr. Oliveira noted that appellant was experiencing 

continued left hip pain. He reviewed MRI scans of her left hip and diagnosed tensor fascia lata 

syndrome and tensor fascia lata avulsion tear.

In a February 26, 2019 report, Dr. Oliveira recounted appellant’s history of injury on 

December 6, 2018. He opined that she developed a full-thickness tear of the left tensor fascia lata 

tendon, strain of the gluteus maximus muscle, left hip trochanteric bursitis, and a labral tear. 

Dr. Oliveira noted that treatment consisted of weight-bearing restrictions, physical therapy 

treatment, and bursa and hip injections. He indicated that recovery could take up to six months 

and would require extensive rehabilitation and work modification. 

On February 28, 2019 appellant requested a review of the written record before an OWCP 

hearing representative. 

An after-visit summary, dated December 19, 2018, showed that appellant saw Dr. Farah 

Tejpar, a Board-certified specialist in sports medicine, for a rupture of the tendon of the hip and a 

strain of the gluteus maximus.

In a February 15, 2019 report, Dr. Oliveira noted that appellant reported mild improvement 

in her left hip symptoms. He examined her and diagnosed trochanteric bursitis of the left hip and 

tensor fascia lata syndrome. Dr. Oliveira recommended a left greater trochanteric bursa injection. 

By decision dated June 4, 2019, OWCP’s hearing representative affirmed the January 30, 

2019 decision. 
4

LEGAL PRECEDENT

An employee seeking benefits under FECA2 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 The opinion of the physician must be based on a complete factual 

and medical background of the claimant, 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 identified by the claimant.9

Under section 8101(2) of FECA, chiropractors are only considered physicians to the extent 

that they treat spinal subluxations as demonstrated by x-ray to exist.10 OWCP’s implementing 

regulations provide that reimbursable chiropractic services are limited to physical examinations 

(and related laboratory tests), x-rays performed to diagnose a subluxation of the spine, and 

treatment consisting of manual manipulation of the spine to correct a subluxation.11

 

2

Id.

3 G.L., Docket No. 18-1057 (issued April 14, 2020); J.P., 59 ECAB 178 (2007); Joe D. Cameron, 41 ECAB 

153 (1989).

4 M.G., Docket No. 18-1616 (issued April 9, 2020); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40 ECAB 

312 (1988).

5 20 C.F.R. § 10.115; A.S., Docket No. 19-1955 (issued April 9, 2020); L.M., Docket No. 13-1402 (issued 

February 7, 2014); Delores C. Ellyett, 41 ECAB 992 (1990).

6 R.K., Docket No. 19-0904 (issued April 10, 2020); Elaine Pendleton, 40 ECAB 1143 (1989).

7 Y.D., Docket No. 19-1200 (issued April 6, 2020); John J. Carlone, 41 ECAB 354 (1989).

8 L.F., Docket No. 19-1905 (issued April 10, 2020); Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000).

9 A.S., supra note 5; Leslie C. Moore, 52 ECAB 132 (2000).

10 5 U.S.C. § 8101(2); see D.J., Docket No. 19-1494 (issued March 11, 2020).

11 20 C.F.R. § 10.5(o).
5

ANALYSIS

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

condition causally related to the accepted December 6, 2018 employment incident.

OWCP received a series of after-visit summaries from Dr. McCoy, Dr. Tejpar and

Dr. Oliveira, dated From December 7 to 28, 2018. While these summaries provided diagnoses of 

appellant’s left hip condition, they did not provide an opinion on the issue of causal relationship. 

The Board has held that medical evidence that does not include an opinion regarding the cause of

an employee’s condition is of no probative value on the issue of causal relationship.12 As such, 

these reports are insufficient to establish appellant’s claim. 

Appellant submitted medical reports from Dr. Oliveira dated December 14, 2018 through 

February 26, 2019. Dr. Oliveira diagnosed left hip pain, closed fracture of the left hip, tensor 

fascia lata syndrome, a full-thickness tear of the left tensor fascia lata tendon, strain of the gluteus 

maximus muscle, left hip trochanteric bursitis, and a labral tear. While he noted appellant’s history 

of injury, he failed to address causal relationship in his reports. As noted, the Board has held that 

medical evidence that does not include an opinion regarding the cause of an employee’s condition 

is of no probative value on the issue of causal relationship.13 As such, these reports from

Dr. Oliveira are insufficient to establish appellant’s claim.

Appellant also submitted Part B of a December 28, 2018 Form CA-16 report, a 

December 28, 2018, and a January 21, 2019 Form CA-20 report all from Dr. Oliveira. In these 

reports, Dr. Oliveira diagnosed tensor fascia lata syndrome and left tensor fascia lata avulsion tear. 

He checked a box marked “Yes” indicating that the conditions were caused or aggravated by 

appellant entering her work vehicle. However, the Board has held that when a physician’s opinion 

on causal relationship consists only of checking “Yes” to a form question, without explanation or 

medical rationale, that opinion is of diminished probative value.14 Accordingly, these reports are 

also insufficient to establish appellant’s claim.

Appellant also submitted a Form CA-17 completed by Dr. Oliveira. However, this is 

merely a form report and does not contain a clear opinion on whether the accepted employment 

injury caused disability from employment for the claimed period; consequently, it is of no 

probative value on the issue of causal relationship.15 The Board has held that medical evidence 

that does not offer an opinion regarding the cause of an employee’s condition or disability is of no 

probative value on the issue of causal relationship.16 Therefore, this form report is insufficient to 

establish appellant’s claim.

 

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

13 Id.

14 W.M., Docket No. 19-1853 (issued May 13, 2020).

15 Supra note 12.

16 A.A., Docket No. 19-0957 (issued October 22, 2019); L.D., Docket No. 19-0263 (issued June 19, 2019).
6

Appellant submitted physical therapy treatment notes dated January 10, 2019. The Board 

has held that medical notes signed solely by physical therapists are of no probative value as such 

healthcare providers are not considered physicians as defined under FECA.17 These notes are 

therefore insufficient to establish appellant’s claim.

The record also contains x-rays and MRI scans of appellant’s pelvis and hips. The Board 

has held, however, that diagnostic tests standing alone lack probative value as they do not provide 

an opinion on causal relationship between an employment incident and a diagnosed condition.18

As appellant has not submitted rationalized medical evidence establishing causal 

relationship between her diagnosed left hip conditions and the accepted December 6, 2018 

employment incident, the Board finds that she has not met her burden of proof.19

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 left hip 

condition causally related to the accepted December 6, 2018 employment incident.

 

17 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). See also 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); S.K., Docket 

No. 18-1414 (issued April 29, 2020) (physical therapists are not considered physicians under FECA).

18 L.F., supra note 8.

19 The Board notes that the employing establishment issued a Form CA-16. A completed Form CA-16 authorization 

may constitute a contract for payment of medical expenses to a medical facility or physician, when properly executed. 

The form creates a contractual obligation, which does not involve the employee directly, to pay for the cost of the 

examination or treatment regardless of the action taken on the claim. See 20 C.F.R. § 10.300(c); J.G., Docket No. 

17-1062 (issued February 13, 2018); Tracy P. Spillane, 54 ECAB 608 (2003).
7

ORDER

IT IS HEREBY ORDERED THAT the June 4, 2019 of the Office of Workers’

Compensation Programs is affirmed.

Issued: June 26, 2020

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