United States Department of Labor

Employees’ Compensation Appeals Board

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D.H., Appellant

and

DEPARTMENT OF JUSTICE, FEDERAL 

BUREAU OF INVESTIGATION, Boston, MA, 

Employer

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Docket No. 18-0072

Issued: January 21, 2020

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

CHRISTOPHER J. GODFREY, Chief Judge

PATRICIA H. FITZGERALD, Deputy Chief Judge

JANICE B. ASKIN, Judge

JURISDICTION

On October 11, 2017 appellant filed a timely appeal from a July 5, 2017 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 his burden of proof to establish a right upper 

extremity condition causally related to the accepted December 9, 2016 employment incident.

FACTUAL HISTORY

On December 13, 2016 appellant, then a 56-year-old information technology specialist, 

filed a traumatic injury claim (Form CA-1) alleging that on December 9, 2016 he injured his right 

 

1 5 U.S.C. § 8101 et seq.
2

shoulder and upper right arm when installing computers and moving portable walls while in the 

performance of duty. On the reverse side of the claim form the employing establishment noted 

that its knowledge of the facts about the injury aligned with his statements. Appellant did not stop 

work.

On December 15, 2016 x-rays of appellant’s right shoulder revealed: moderate 

glenohumeral narrowing and hypertrophic change; moderate hypertrophic change of the 

acromioclavicular joint; a small focus of mineralization superior to the greater tuberosity, possibly 

reflecting calcific tendinosis; and a spall possible projecting over the axillary recess. No acute 

fracture or dislocation was noted.

On December 15, 2016 Dr. Elizabeth Matzkin, a Board-certified orthopedic surgeon, 

examined appellant for complaints for right shoulder pain. She noted that she had last seen him in 

August 2014 for his right shoulder and that he had been doing fairly well. Appellant reported that,

less than one week prior, he was at work moving wall dividers when he jammed his right shoulder.

He did not experience pain until he was driving home. On physical examination Dr. Matzkin noted 

no tenderness, full muscle strength with pain at the subscapularis, and positive impingement and 

Hawkins’ tests. She noted that appellant’s right shoulder range of motion was 80 degrees active 

abduction, 140 degrees active forward flexion, 70 degrees of external rotation, and internal rotation

at 90 degrees of 40 degrees. Dr. Matzkin diagnosed right shoulder glenohumeral osteoarthritis 

exacerbation. She noted the December 9, 2016 employment incident and indicated that appellant 

may also have a partial thickness supraspinatus tear. Dr. Matzkin performed an injection into his 

right subacromial space and glenohumeral joint.

On January 23, 2017 Dr. Matzkin examined appellant and in her report she noted that his 

right shoulder displayed the same ranges of motion, tenderness, muscle strength, and positive tests 

as on December 15, 2017. She indicated that he had attended physical therapy since their last 

meeting and that his pain had decreased. Dr. Matzkin diagnosed a right shoulder glenohumeral 

osteoarthritis exacerbation and a likely partial thickness supraspinatus tear. She recommended 

that appellant continue physical therapy. Dr. Matzkin again examined him on April 27, 2017 and 

noted that he had not kept up with physical therapy exercises.

Appellant submitted physical therapy treatment notes covering the period December 22, 

2016 through January 19, 2017. 

On May 4, 2017 appellant informed Dr. Matzkin that he had another injury at work on 

May 1, 2017, but that his pain had improved since that time. On physical examination Dr. Matzkin 

noted no tenderness, full muscle strength with pain at the supraspinatus, and positive impingement 

and Hawkins’ tests. Appellant’s right shoulder range of motion was 160 degrees forward flexion,

80 degrees external rotation, internal rotation at 0 degrees of “lumbar,” and internal rotation at 

90 degrees of 60 degrees. Dr. Matzkin diagnosed a right shoulder glenohumeral osteoarthritis 

exacerbation and a possible partial thickness rotator cuff tear. She noted that appellant’s pain and 

limitations were mostly attributable to his osteoarthritis. Appellant refused an additional steroid 

injection.

In a development letter dated June 2, 2017, OWCP informed appellant that the evidence 

submitted was insufficient to establish his claim. It explained the medical evidence needed to 
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establish his claim and advised that appellant’s physician should differentiate his claimed injury 

from the symptoms of preexisting right shoulder and arm injuries, as well as subsequent injuries. 

OWCP noted appellant’s prior injuries to his right shoulder and arm under OWCP File 

Nos. xxxxxx457 and xxxxxx626, as well as the subsequent right shoulder injury on April 18, 2017 

under OWCP File No. xxxxxx315. It requested that he respond to its inquiries and afforded him 

30 days to submit additional evidence. Appellant did not respond.

By decision dated July 5, 2017, OWCP denied appellant’s claim, finding that he had not 

submitted sufficient evidence to establish causal relationship between a right shoulder condition

and the accepted December 9, 2016 employment incident. 

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 filed within the applicable time 

limitation period of FECA,3that an injury was sustained while in the performance of duty, as 

alleged, and that any disability or specific 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 on a traumatic injury or an 

occupational disease.5

To determine whether an employee 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, which must be considered in conjunction with one another. The first 

component to be established is that the employee actually experienced the employment incident 

which is alleged to have occurred.6 The second component is whether the employment incident 

caused a personal injury.7

Causal relationship is a medical issue, and the medical evidence required to establish causal 

relationship is rationalized medical evidence.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 

 

2

Id.

3 See R.B., Docket No. 18-1327 (issued December 31, 2018); J.P., 59 ECAB 178 (2007); Joe D. Cameron, 41 

ECAB 153 (1989).

4 Y.K., Docket No. 18-0806 (issued December 19, 2018); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40 

ECAB 312 (1988).

5 R.R., Docket No. 19-0048 (issued April 25, 2019); Delores C. Ellyett, 41 ECAB 992 (1990).

6 R.E., Docket No. 17-0547 (issued November 13, 2018); Elaine Pendleton, 40 ECAB 1143 (1989).

7 D.C., Docket No. 18-1664 (issued April 1, 2019); John J. Carlone, 41 ECAB 354 (1989).

8 L.D., Docket No. 17-1581 (issued January 23, 2018); Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000).
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between the diagnosed condition and the specific employment factors identified by the employee.9 

Neither the mere fact that a disease or condition manifests itself during a period of employment, 

nor the belief that the disease or condition was caused or aggravated by employment factors or 

incidents is sufficient to establish causal relationship.10

In a case where a preexisting condition involving the same part of the body is present and 

the issue of causal relationship therefore involves aggravation, acceleration, or precipitation, the 

physician must provide a rationalized medical opinion that differentiates between the effects of the 

work-related injury or disease and the preexisting condition.11

Certain healthcare providers such as physician assistants, nurse practitioners, physical 

therapists, and social workers are not considered “physician[s]” as defined under FECA.12 

Consequently, their medical findings and/or opinions will not suffice for purposes of establishing 

entitlement to FECA benefits.13

ANALYSIS

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

extremity condition causally related to the accepted December 9, 2016 employment incident. 

In support of his claim, appellant submitted a series of medical reports from Dr. Matzkin. 

Dr. Matzkin noted that he had a preexisting right shoulder injury in August 2014 for his right 

shoulder and noted that he had progressed well. She noted appellant’s history of injury and 

conducted a physical examination. Dr. Matzkin diagnosed a right shoulder glenohumeral 

osteoarthritis exacerbation, indicating that he may also have a partial thickness supraspinatus tear, 

and noting a work injury on December 9, 2016. In her May 4, 2017 report, she noted that 

appellant’s pain and limitations were mostly attributable to his osteoarthritis and that he sustained 

an additional employment injury to his right shoulder on May 1, 2017. The Board finds that none 

of the reports of Dr. Matzkin provide an opinion on the issue of causal relationship. Medical 

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

 

9 L.D., id.; see also Leslie C. Moore, 52 ECAB 132 (2000); Gary L. Fowler, 45 ECAB 365 (1994).

10 T.H., Docket No. 18-1736 (issued March 13, 2019); Dennis M. Mascarenas, 49 ECAB 215 (1997).

11 Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.805.3e (January 2013).

12 5 U.S.C. § 8101(2); 20 C.F.R. § 10.5(t).

13 Id. at U.S.C. § 8101(2) (defining a physician as surgeons, podiatrists, dentists, clinical psychologists, 

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

K.W., 59 ECAB 271, 279 (2007); David P. Sawchuk, 57 ECAB 316, 320 n.11 (2006). A report from a physician 

assistant or certified nurse practitioner will be considered medical evidence if countersigned by a qualified physician. 

Supra note 11 at Chapter 2.805.3a(1).
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probative value on the issue of causal relationship.14 As such, the reports from Dr. Matzkin are 

insufficient to establish a work-related injury to appellant’s right shoulder on December 9, 2016.15

Appellant submitted a diagnostic study of his right shoulder in support of his claim. The 

Board has held, however, that diagnostic studies lack probative value on the issue of causal 

relationship, as they do not address whether the employment incident caused an exacerbation of 

his right shoulder conditions.16 Thus, the diagnostic study is insufficient to establish appellant’s 

claim.

Appellant also submitted physical therapy reports. Reports signed by physical therapists, 

without a countersignature from a physician, have no probative value, as physical therapists are 

not considered physicians as defined under FECA.17

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

relationship between appellant’s right upper extremity condition and the December 9, 2016 

employment incident, the Board finds that he 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 a right upper 

extremity condition causally related to the accepted December 9, 2016 employment incident.

 

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

15 See C.R., Docket No. 17-1681 (issued December 1, 2017).

16 See J.S., Docket No. 17-1039 (issued October 6, 2017). 

17 Supra note 13.
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ORDER

IT IS HEREBY ORDERED THAT the July 5, 2017 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: January 21, 2020

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board