United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

E.B., Appellant

and

U.S. POSTAL SERVICE, PROCESSING & 

DISTRIBUTION CENTER, Coppell, TX, 

Employer

__________________________________________

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Docket No. 19-1548

Issued: July 14, 2020

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

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 July 15, 2019 appellant, through counsel, filed a timely appeal from an April 29, 2019 

merit decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to the 

Federal Employees’ Compensation Act2(FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board 

has jurisdiction over the merits of this case.3

 

1

In all cases in which a representative has been authorized in a matter before the Board, no claim for a fee for legal 

or other service performed on appeal before the Board is valid unless approved by the Board. 20 C.F.R. § 501.9(e). 

No contract for a stipulated fee or on a contingent fee basis will be approved by the Board. Id. An attorney or 

representative’s collection of a fee without the Board’s approval may constitute a misdemeanor, subject to fine or 

imprisonment for up to one year or both. Id.; see also 18 U.S.C. § 292. Demands for payment of fees to a 

representative, prior to approval by the Board, may be reported to appropriate authorities for investigation.

2 5 U.S.C. § 8101 et seq.

3 The Board notes that, following the April 29, 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 additional 

evidence for the first time on appeal. Id.
2

ISSUE

The issue is whether appellant has met her burden of proof to establish disability from work

for the period December 4, 2016 through August 13, 2017 causally related to her accepted 

November 21, 2016 employment injury.

FACTUAL HISTORY

On March 15, 2018 appellant, then a 45-year-old former rural carrier associate, filed a 

traumatic injury claim (Form CA-1) alleging that on November 21, 2016 she broke her left index 

finger when she fell after missing a step in front of a home on her delivery route while in the 

performance of duty.4 OWCP accepted her claim for closed displaced fracture of the medial 

phalanx of the left index finger. 

Appellant submitted a February 7, 2018 report from Dr. Lan Hua, a Board-certified hand 

surgeon, who examined appellant for complaints of left index finger pain at the proximal 

interphalangeal joint (PIP), and bilateral wrist pain, numbness, and tingling. She reported to

Dr. Hua that she had fallen on her left hand at work in November 2016. Dr. Hua diagnosed 

bilateral wrist pain, bilateral cubital tunnel syndrome, left finger osteoarthritis, and sequela of a 

closed displaced fracture of the middle phalanx of the left index finger. She advised against 

surgery due to the age of the left index finger fracture and recommended that appellant undergo 

occupational therapy. 

Appellant submitted a partial report dated February 26, 2018 from Dr. Victoria Knoll, a 

Board-certified hand surgeon, who reviewed an x-ray of appellant’s left hand, observing old healed 

fractures at the PIP and the radial base of the distal phalanx of the left index finger. Dr. Knoll

diagnosed bilateral lesions of the ulnar nerve of the upper limbs and left hand stiffness, and noted 

that appellant’s healed left finger fractures did not appear to necessitate surgery.

On May 11, 2018 appellant filed a claim for wage-loss compensation (Form CA-7) due to 

disability from work for the period December 4, 2016 through August 13, 2017. On the employing

establishment’s portion of the Form CA-7, a supervisor noted that appellant had been separated 

from service on December 4, 2016, and advised that he was unable to certify the claim as her injury 

had been reported to a physician two years after the date of injury. In an attached letter, the 

supervisor recalled that appellant entered duty on October 29, 2016 and voluntarily resigned on 

December 4, 2016 without giving a reason.

5

By letter dated May 23, 2018, OWCP requested that appellant submit additional evidence 

in support of her claim for wage-loss compensation, including a medical report explaining how 

her employment-related condition worsened such that she was no longer able to perform the duties 

of her position when she stopped work on December 4, 2016. It afforded her 30 days to respond. 

 

4 Appellant voluntarily resigned from her position at the employing establishment on December 4, 2016. 

5

In a time analysis form (Form CA-7a) accompanying her claim, appellant reported a total of 1,128 hours of leave 

without pay due to an injured left index finger. An employing establishment official was unable to certify that the 

claimed dates were accurate, as there was no medical evidence supporting temporary total disability and appellant had 

been separated from service. In an attached notification of personnel action (PS Form-50), it was noted that appellant 

had voluntarily resigned on December 4, 2016 and gave no reason for the resignation. 
3

Appellant submitted a June 17, 2018 statement in which she explained that she separated 

from the employing establishment on December 4, 2018 because she continually injured her 

fractured left index finger and both her hands while working. 

In a June 12, 2018 report, Dr. Knoll advised that appellant reported sustaining a finger 

injury in November 2016 and noted that she first examined her on February 26, 2018 at which 

time the physical examination of her left index finger revealed stiffness upon range of motion 

(ROM) without instability/laxity of any joint. She related that x-ray testing demonstrated a healed 

fracture at the radial base of the proximal phalanx of the index finger and a possible healed volar 

plate avulsion. Dr. Knoll indicated that appellant reported difficulty performing her work duties

after the injury, but appellant noted that she was unable to make a statement of any functional 

impairment in her left index finger prior to February 26, 2018. She attached a complete copy of 

her February 26, 2018 report in which she noted that the examination of even date revealed 

moderately decreased ROM of the left index finger. Dr. Knoll reviewed a February 26, 2018 x-ray 

of the left index finger and diagnosed bilateral lesions of the ulnar nerve of the upper extremities

and left hand stiffness.6

Appellant also submitted administrative documents regarding her participation in 

occupational therapy treatment and a May 22, 2018 report from Kristen Keesey, an occupational 

therapist, who described a therapy session conducted on even date. 

By decision dated August 22, 2018, OWCP denied appellant’s claim for wage-loss 

compensation for disability from work for the period December 4, 2016 through August 13, 2017. 

It found that the medical evidence of record failed to provide clinical objective findings from a 

treating physician that supported her inability to work for the claimed period. 

On September 14, 2018 appellant, through counsel, requested a telephonic hearing before 

a representative of OWCP’s Branch of Hearings and Review.7

Appellant submitted a January 3, 2019 report from Dr. Jordan Pastorek, a Board-certified 

internist, who noted that she reported a November 21, 2016 employment injury to her left index 

finger. She asserted that she had resigned from the employing establishment due to her inability 

to perform the duties of her position after the incident. On physical examination of the left upper 

extremity, Dr. Pastorek observed positive Finkelstein’s, Phalen’s, and bracelet tests with limited 

ROM and moderate pain on palpation of the left index finger. He diagnosed closed displaced 

fracture of the middle phalanx of the left index finger. 

In follow-up reports dated January 14, 15, 16, 21, 23, 24, 28, 29, and 31 and February 6, 

2019, Dr. Pastorek reported findings for the examinations of appellant’s left upper extremity 

conducted on these dates, including pain/tenderness to palpation of the left index finger. He 

diagnosed closed displaced fracture of the middle phalanx of the left index finger and noted that 

appellant had performed rehabilitative/therapeutic exercises on these dates. 

 

6 Appellant had previously submitted a partial copy of Dr. Knoll’s February 26, 2018 report.

7 Appellant submitted an August 23, 2018 letter in which she discussed OWCP’s handling of her compensation 

claim. 
4

A hearing before OWCP’s hearing representative was held on February 12, 2019, during 

which appellant discussed her left upper extremity symptoms. 

After the hearing, appellant submitted reports dated February 7, 11, 14, 19, 21, 25, 26, and 

28, March 5, 7, 11, 21, 25, and 28, and April 2 and 16, 2019 from Dr. Pastorek who noted 

examination findings, including pain/tenderness to palpation of the left index finger, and diagnosed 

closed displaced fracture of the middle phalanx of the left index finger. 

Appellant also submitted reports from nurse practitioners, including February 27, 

March 11 and 25, 2019 reports from Jessica Gerhart, and March 21 and April 9, 2019 reports from 

Maziana Abiad.

By decision dated April 29, 2019, OWCP’s hearing representative affirmed the August 22, 

2019 decision. 

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 any disability or specific condition for 

which compensation is claimed is causally related to the employment injury.8 

Under FECA the term “disability” means the incapacity, because of an employment injury, 

to earn the wages that the employee was receiving at the time of injury.9 Disability is thus not 

synonymous with physical impairment, which may or may not result in an incapacity to earn 

wages.10 An employee who has a physical impairment causally related to a federal employment 

injury, but who nevertheless has the capacity to earn the wages he or she was receiving at the time 

of injury, has no disability as that term is used in FECA.11 When, however, the medical evidence 

establishes that the residuals or sequelae of an employment injury are such that, from a medical 

standpoint, they prevent the employee from continuing in his or her employment, he or she is 

entitled to compensation for loss of wages.12

The medical evidence required to establish causal relationship between a claimed period 

of disability and an employment injury is rationalized medical opinion evidence. 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 claimed disability and the accepted employment injury.13

The Board will not require OWCP to pay compensation for disability in the absence of 

medical evidence directly addressing the specific dates of disability for which compensation is 

 

8 S.W., Docket No. 18-1529 (issued April 19, 2019); J.F., Docket No. 09-1061 (issued November 17, 2009).

9 20 C.F.R. § 10.5(f).

10 See L.W., Docket No. 17-1685 (issued October 9, 2018).

11 See K.H., Docket No. 19-1635 (issued March 5, 2020).

12 See D.R., Docket No. 18-0323 (issued October 2, 2018).

13 Y.S., Docket No. 19-1572 (issued March 12, 2020).
5

claimed. To do so, would essentially allow an employee to self-certify their disability and 

entitlement to compensation.14

ANALYSIS

The Board finds that appellant has not met her burden of proof to establish disability from 

work for the period December 4, 2016 through August 13, 2017 causally related to her accepted 

November 21, 2016 employment injury.

Appellant submitted a February 7, 2018 report from Dr. Hua, who noted that appellant 

reported injuring her left index finger at work on November 21, 2016. Dr. Hua diagnosed several 

medical conditions, including sequela of a closed displaced fracture of the middle phalanx of the 

left index finger.

15

 In a partial report dated February 26, 2018, Dr. Knoll diagnosed bilateral 

lesions of the ulnar nerve of the upper limbs and left hand stiffness. In a report dated June 12, 

2018, she advised that she was unable to address any functional impairment in appellant’s left 

index finger prior to February 26, 2018. In reports dated from January 3 through April 16, 2019,

Dr. Pastorek followed up with appellant for her left upper extremity problems and consistently 

diagnosed closed displaced fracture of the middle phalanx of the left index finger. The Board 

notes, however, that Drs. Hua, Knoll, and Pastorek did not provide an opinion as to whether 

appellant was disabled from work during the claimed period, i.e., December 4, 2016 through 

August 13, 2017, due to her accepted November 21, 2016 employment injury. 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, the abovenoted reports are of no probative value with regard to the issue of appellant’s disability for the 

claimed period, and they are insufficient to establish her claim for wage-loss compensation. 

Appellant submitted reports from nurse practitioners, including February 27, March 11, 

and 25, 2019 reports from Ms. Gerhart, and March 21 and April 9, 2019 reports from Ms. Abiad. 

She also submitted a May 22, 2018 report from Ms. Keesey, an occupational therapist. However, 

these reports do not constitute competent medical evidence because nurse practitioners and 

occupational therapists are not considered “physicians” as defined under FECA.17 Consequently, 

the medical findings and/or opinions of Ms. Gerhart and Ms. Abiad will not suffice for purposes 

 

14 A.W., Docket No. 18-0589 (issued May 14, 2019).

15 OWCP accepted that on November 21, 2016 appellant sustained a closed displaced fracture of the medial phalanx 

of her left index finger.

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

17 5 U.S.C. § 8101(2) provides that a physician includes surgeons, podiatrists, dentists, clinical psychologists, 

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

See also 20 C.F.R. § 10.5(t); 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); L.C., Docket 

No. 16-1717 (issued March 2, 2017) (a nurse is not considered a physician under FECA); R.S., Docket No. 16-1303 

(issued December 2, 2016) (an occupational therapist is not considered a physician under FECA).
6

of establishing entitlement to compensation benefits.18 As such, these reports are of no probative 

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

19

As the medical evidence of record does not include a rationalized opinion on causal 

relationship between appellant’s claimed disability and her accepted November 21, 2016 

employment injury, 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 disability from 

work for the period December 4, 2016 through August 13, 2017 causally related to her accepted 

November 21, 2016 employment injury.

ORDER

IT IS HEREBY ORDERED THAT the April 29, 2019 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: July 14, 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

 

18 Id. 

19 See L.A., Docket No. 19-0820 (issued December 6, 2019); K.C., Docket No. 16-1181 (issued July 26, 2017).