United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

C.K., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Springfield, MA, Employer

__________________________________________

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Docket No. 19-1549

Issued: June 30, 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 a May 7, 2019 

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

Federal Employees’ Compensation Act2and 20 C.FR. §§ 501.2(c) and 501.3, the Board has 

jurisdiction over the merits of this case. 

 

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.
2

ISSUE

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

condition causally related to the accepted factors of her federal employment.

FACTUAL HISTORY

On June 9, 2018 appellant, then a 59-year-old mail handler, filed an occupational disease 

claim (Form CA-2) alleging that she injured her left shoulder causally related to factors of her 

federal employment, including continuously lifting heavy trays overhead while working with a

flats sequencing system (FSS). She indicated that she first became aware of her condition and of 

its relationship to her federal employment on January 6, 2016.

By development letter dated June 21, 2018, OWCP informed appellant that the evidence 

of record was insufficient to establish her claim. It advised her of the type of factual and medical 

evidence needed and provided a questionnaire for her completion. OWCP afforded appellant 30 

days to submit additional evidence and to respond to its inquiries.

Appellant certified the questionnaire on June 26, 2018. She explained that in addition to 

working the FSS, her work activities of moving boxes of magazines manually while using a manual 

pallet jack, continuously lifting magazines in tubs to be placed in a postal container, and cutting 

plastic from bundles of magazines to place into dolly makers also caused or contributed to her 

injury. Appellant reported that she had performed these activities as eight-hour assignments, that 

she was usually assigned to lifting street trays, and that she had worked in her position for over 

eight years. 

Medical evidence submitted included a March 14, 2016 chest x-ray that demonstrated no 

lung disease, but an incompletely-visualized radiolucent lesion proximal to the humeral shaft with 

adjacent matrix calcification/sclerosis of the proximal humeral metaphysis.

Based on the chest x-ray findings, a March 25, 2016 x-ray of the left shoulder demonstrated 

a benign-appearing bone lesion of the proximal left humerus, degenerative changes, and possible 

calcific tendinitis/bursitis.

A January 8, 2018 left shoulder x-ray demonstrated osteoarthritis of the left 

acromioclavicular (AC) joint and a focal sclerotic bone lesion proximal to the left humeral 

metaphysis which was considered benign and most likely represented bone infarct or 

enchondroma.

A May 12, 2018 magnetic resonance imaging (MRI) scan of the left shoulder demonstrated 

findings suggestive of enchondroma of the proximal humerus, degenerative changes in the AC 

joint and labrum, and a significant partial tear of the supraspinatus tendon.

In a report dated August 3, 2018, Melissa Mol-Pelton, a physician assistant, noted 

complaints of left shoulder pain. She indicated that appellant reported a history that she had hurt 

her left shoulder at work two years previously. Ms. Mol-Pelton described left shoulder 

examination findings and reviewed the May 12, 2018 MRI scan. She diagnosed a small left 

shoulder high-grade partial rotator cuff tear, administered an injection, and recommended work 
3

restrictions. Ms. Mol-Pelton also provided a physical therapy referral. Appellant submitted 

physical therapy treatment notes dated August 27 and 30, 2018.

By decision dated September 11, 2018, OWCP denied appellant’s claim, finding that the 

medical evidence of record was insufficient to establish that her left shoulder condition was 

causally related to the accepted factors of her federal employment.

On September 19, 2018 appellant, through counsel, requested a telephonic hearing before 

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

Appellant submitted a record of her attendance at physical therapy appointments from 

August 27 through October 16, 2018, physical therapy exercise diagrams dated August 27, 2018, 

and physical therapy notes dated September 11 through October 9, 2018.

In a treatment note dated September 14, 2018, Dr. Jennie Garver, a Board-certified 

orthopedic surgeon, advised that she was treating appellant for a left shoulder partial-thickness 

rotator cuff tear and AC arthrosis. She reported a history that appellant had injured her shoulder 

on January 6, 2016 when lifting trays of magazines overhead and felt soreness in her shoulder at 

the end of the day, without a specific episode setting off the pain. On examination of the left upper 

extremity, Dr. Garver noted tenderness to palpation at the AC joint and subacromial space, forward 

elevation to 165 degrees, positive Neer’s and Hawkins tests, passive external rotation to 65 

degrees, internal rotation to T12, mild discomfort superiorly with the extremes of internal and 

external rotation, a positive cross-body adduction test, and a positive Speed’s test. She reviewed 

an August 3, 2018 x-ray done at her office and the May 12, 2018 MRI scan. Dr. Garver diagnosed 

a medium grade partial thickness interstitial cuff tear as well as severe AC arthrosis, noting less 

pain with cuff testing than with provocation of the AC joint. She administered an AC joint 

injection and recommended continued physical therapy and work restrictions. 

At the hearing, held telephonically on February 15, 2019, appellant described her work 

activities from January 2016 which, she maintained, caused her rotator cuff tear. The hearing 

representative informed appellant and counsel of the specific evidence needed and held the record 

open for 30 days for the submission of additional evidence. Nothing further was submitted.

By decision dated May 7, 2019, an OWCP hearing representative affirmed the 

September 11, 2018 decision. He found that the medical evidence of record was insufficient to 

establish causal relationship between appellant’s left shoulder condition and the accepted factors 

of her federal employment.

LEGAL PRECEDENT

An employee seeking benefits under FECA3 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 of FECA, that 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 

 

3 Supra note 2.
4

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 establish that an injury was sustained in the performance of duty in an occupational 

disease claim, a claimant must submit: (1) a factual statement identifying employment factors 

alleged to have caused or contributed to the presence or occurrence of the disease or condition; 

(2) medical evidence establishing the presence or existence of the disease or condition for which 

compensation is claimed; and (3) medical evidence establishing that the diagnosed condition is 

causally related to the identified employment factors.6

Causal relationship is a medical question that requires rationalized medical opinion 

evidence to resolve the issue.7 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.8

ANALYSIS

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

condition causally related to the accepted factors of her federal employment.

In her September 14, 2018 report, Dr. Garver provided the diagnoses of medium grade 

partial thickness interstitial cuff tear and severe AC arthrosis. She noted a history that on 

January 6, 2016, appellant lifted trays of magazines overhead and felt soreness in her shoulder at 

the end of the day, without a specific episode setting off the pain. Dr. Garver, however, did not 

offer an opinion regarding the cause of appellant’s diagnosed conditions. The Board has held that 

reports that do not provide an opinion on causal relationship are of no probative value. Therefore 

this report is insufficient to establish the claim.9

Appellant submitted reports from a Ms. Mol-Pelton, a physician assistant, dated August 3, 

2018 and treatment notes from physical therapists. Certain healthcare providers such as physician 

assistants, nurse practitioners, physical therapists, and social workers are not considered 

 

4 R.G., Docket No. 19-0233 (issued July 16, 2019); Elaine Pendleton, 40 ECAB 1143 (1989).

5

Id. 

6 L.D., Docket No. 19-1301 (issued January 29, 2020); S.C., Docket No. 18-1242 (issued March 13, 2019); Victor J. 

Woodhams, 41 ECAB 345, 352 (1989).

7

I.J., Docket No. 19-1343 (issued February 26, 2020); T.H., 59 ECAB 388 (2008); Robert G. Morris, 48 ECAB 

238 (1996).

8 D.J., Docket No. 19-1301 (issued January 29, 2020).

9 L.B., Docket No. 18-0533 (issued August 27, 2018); D.K., Docket No. 17-1549 (issued July 6, 2018).
5

“physician[s]” as defined under FECA.10 Consequently, these reports and/or opinions will not 

suffice for purposes of establishing appellant’s claim.11

As to the diagnostic reports dated March 14 and 25, 2016, and January 8 and May 12, 2018, 

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

an opinion on causal relationship between accepted employment factors and a claimant’s 

diagnosed condition.12 These reports are, therefore, insufficient to establish appellant’s claim.

As the medical evidence of record is insufficient to establish a left shoulder condition 

causally related to the accepted employment factors, the Board finds that she has not met her 

burden of proof to establish her claim.

On appeal counsel argues that OWCP failed to apply the proper causation standard and 

failed to give due deference to the attending physician. As explained above, the Board finds that 

the medical evidence of record is insufficient to meet appellant’s 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 left shoulder 

condition causally related to the accepted factors of her federal employment.

 

10 Section 8101(2) of FECA provides that medical opinions can only be given by a qualified physician. This section 

defines a physician as 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 M.M., Docket No. 20-0019 (issued May 6, 2020); K.W., 59 ECAB 271, 279 (2007); David P. Sawchuk, 

57 ECAB 316, 320 n.11 (2006); see also E.T., Docket No. 17-0265 (issued May 25, 2018) (physician assistants are 

not considered physicians under FECA).

11 Id.

12 See P.L., Docket No. 19-1750 (issued March 26, 2020); C.F., Docket No. 18-1156 (issued January 22, 2019); 

T.M., Docket No. 08-0975 (issued February 6, 2009).
6

ORDER

IT IS HEREBY ORDERED THAT the May 7, 2019 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: June 30, 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