United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

D.J., Appellant

and

U.S. POSTAL SERVICE, EASTERN SHORE 

PROCESSING & DISTRIBUTION FACILITY, 

Easton, MD, Employer

__________________________________________

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Docket No. 19-1387

Issued: December 20, 2019

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

PATRICIA H. FITZGERALD, Deputy Chief Judge

ALEC J. KOROMILAS, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On June 11, 2019 appellant filed a timely appeal from an April 17, 2019 merit decision of 

the Office of Workers’ Compensation Programs (OWCP).1 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.

ISSUE

The issue is whether appellant met his burden of proof to establish a diagnosed medical 

condition causally related to the accepted July 15, 2018 employment incident.

 

1 Together with his appeal request, pursuant to section 501.5(b) of the Board’s Rules of Procedure (20 C.F.R. 

§ 501.5(b)), appellant timely requested oral argument before the Board. He subsequently withdrew his request on 

August 19, 2019.

2 5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY

On August 2, 2018 appellant, then a 50-year-old labor custodian, filed a traumatic injury 

claim (Form CA-1) alleging that on July 15, 2018 he sustained an injury to the lower right side of 

his back and right hip when cutting hedges while in the performance of duty. On the reverse side 

of the claim form, the employing establishment controverted the claim asserting that appellant’s 

injury was not in the performance of duty as he had requested light-duty work for a nonworkrelated injury. It further noted that he did not report his injury until after he underwent a magnetic

resonance imaging (MRI) scan on August 1, 2018.

In a July 19, 2018 medical note, Dr. Mary Ann Moore, Board-certified in internal 

medicine, indicated that appellant was seen at her office that day and should remain off work until 

July 23, 2018. 

Appellant’s coworker, J.P., noted in an August 2, 2018 witness statement that he and 

appellant were cutting hedges on July 15, 2018 and that appellant did not report any injuries to 

him at that time. The following Tuesday, his supervisor informed him that appellant was off work 

due to a back injury. Appellant later informed J.P. that he had injured his back while cutting the 

hedges. 

In a witness statement of even date, appellant’s coworker, R.M., noted that on July 17, 

2018 appellant informed him that his back was hurting and that he believed he had injured it on 

July 15, 2018 while cutting bushes. 

Appellant’s supervisor, C.G. in a statement of even date, stated that he believed appellant’s 

injury was not work related as appellant had not informed him of his injury until he was at the 

doctor’s office on August 1, 2018. Appellant stated that he informed his supervisor of his injury 

on July 19, 2018 while he was on the telecom and that he may not have heard him.

An August 2, 2018 duty status report (Form CA-17) with an illegible signature diagnosed 

pain in appellant’s right hip and provided work restrictions. 

In an August 2, 2018 medical report, Dr. Michael Carlson, Board-certified in osteopathic 

manipulative therapy, provided that appellant presented with right hip pain and an abnormal 

radiograph. He suggested appellant use over-the-counter medication for pain and to perform 

piriformis and hip flexor stretches. 

Appellant also provided an August 2, 2018 medical note from Megan Murphy, a registered 

nurse, stating that appellant should remain out of work until his follow-up appointment with the 

orthopedics department. 

On August 3, 2018 OWCP received a statement from appellant in which he explained that 

he strained a muscle in his lower back when he leaned over to cut the hedges at the employing 

establishment on July 15, 2018. Appellant noted that he did not experience much pain when it 

happened, but over the next two days he experienced severe pain that made it difficult for him to 

stand or walk. He informed his supervisor on July 19, 2018 of his injury and left work to visit his 

doctor the same day. Appellant further noted that Dr. Moore opined that he should remain out of 
3

work until July 25, 2018 and during a follow-up appointment with this doctor on July 30, 2018, he 

underwent an x-ray that revealed he would need to undergo an MRI scan for further evaluation.

In an August 3, 2018 witness statement, appellant’s coworker, J.B., stated that appellant 

informed her on July 29, 2018 that he had missed time from work after he injured his back. 

The employing establishment submitted an August 3, 2018 letter controverting appellant’s 

claim. It argued that he failed to establish fact of injury as his supervisor did not agree with the 

statements provided in his Form CA-1 and he had not provided medical evidence showing that his 

injury was causally related to the claimed July 15, 2018 employment injury. 

In an August 12, 2018 medical report, Dr. Eric Green, Board-certified in emergency 

medicine, provided that appellant presented with hip pain. He prescribed medication for 

appellant’s pain.

In an August 16, 2018 development letter, OWCP notified appellant that the information 

he submitted was insufficient to support his claim. It advised him of the type of factual and medical 

evidence required to establish his traumatic injury claim and provided a factual questionnaire 

inquiring about the circumstances surrounding his claimed injury for his completion. OWCP also

requested a narrative medical report from appellant’s physician. It further advised that pain was 

not a valid diagnosis, but rather a symptom. OWCP afforded appellant 30 days to respond. 

In response, appellant provided an August 14, 2018 duty status report (Form CA-17) with 

an illegible signature diagnosing right lower back pain and right hip pain and included work 

restrictions.

In response to OWCP’s questionnaire, appellant submitted an August 20, 2018 statement 

wherein he indicated that he self-medicated to alleviate his pain until he was first seen at

Dr. Moore’s office on July 19, 2018. He stated that he did not have any other disability or 

symptoms before his injury and that he did not sustain any other injury between July 15, 2018 and 

the date he first reported his injury to his supervisor. 

In an August 27, 2018 medical report, Walton Reddish, a nurse practitioner, noted 

appellant’s history of injury related to the claimed July 15, 2018 employment incident. He

diagnosed lower back pain, an unspecified disc disorder, and intervertebral disc disorders with 

radiculopathy. Mr. Reddish also advised appellant to avoid aggravating activities and to treat his 

pain with ice and heat. 

A duty status report (Form CA-17) of even date with an illegible signature included a 

diagnosis of resolving lower back pain and provided appellant additional work restrictions.

In an August 28, 2018 medical note, Dr. Moore reported that she saw appellant that day 

and that she cleared him to return to work on September 1, 2018.

By decision dated September 17, 2018, OWCP denied appellant’s traumatic injury claim, 

finding that he had not submitted medical evidence containing a medical diagnosis in connection 

with his injury. It concluded, therefore, that the requirements had not been met to establish an 

injury as defined under FECA.
4

On September 25, 2018 appellant requested a telephonic hearing with a representative of 

OWCP’s Branch of Hearings and Review. 

Appellant also resubmitted copies of Dr. Carlson’s August 2, 2018 medical report and

Dr. Green’s August 12, 2018 medical report.

On February 5, 2019 a telephonic hearing was held before an OWCP hearing 

representative. During the hearing, appellant explained that he was unable to receive a diagnosis 

for his condition because he was unable to undergo an MRI scan. The hearing representative 

advised appellant of the type of medical evidence needed to establish his claim and kept the record 

open for 30 days for the submission of additional evidence. 

Appellant submitted a July 19, 2018 medical note from Lauren Samuel, a nurse 

practitioner, instructing him to take pain medication and use a heating pad to treat his back pain. 

In a February 13, 2019 letter, Dr. Sara Coulbourn, Board-certified in family medicine, 

provided that appellant was seen on July 19, 30, August 14 and 28, 2018 for back and right hip 

pain. She noted that a right hip x-ray was performed on July 30, 2018 and that he was referred to 

an orthopedic doctor for further evaluation. 

By decision dated April 17, 2019, OWCP’s hearing representative modified OWCP’s 

September 17, 2018 decision finding that the July 15, 2018 employment incident occurred as 

alleged. However, she affirmed OWCP’s September 17, 2018 decision, finding that there was no 

rationalized medical evidence of record establishing a causal relationship between a diagnosed 

medical condition and the accepted July 15, 2018 employment incident.

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,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 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 whether a federal employee has sustained a traumatic injury in the 

performance of duty, it first must be determined whether the fact of injury has been established. 

 

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).

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).
5

There are two components involved in establishing the fact of injury. First, the employee must 

submit sufficient evidence to establish that he or she actually experienced the employment incident 

at the time, place, and in the manner alleged. Second, the employee must submit evidence, in the 

form of medical evidence, to establish that the employment incident caused a personal injury.7

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.8 

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.9

ANALYSIS

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

medical condition causally related to the accepted July 15, 2018 employment incident.

Dr. Carlson, in his August 2, 2018 medical report, provided that appellant presented with 

right hip pain and an abnormal radiograph. Similarly, Dr. Green, in his August 12, 2018 medical 

report, diagnosed right hip pain and provided treatment instructions for appellant to follow. The 

Board has held that, under FECA, the assessment of pain is not considered a diagnosis, as pain 

merely refers to a symptom of an underlying condition.10 Accordingly, the reports of Drs. Carlson

and Green are insufficient to establish the claim.

Appellant also provided July 19 and August 28, 2018 medical notes from Dr. Moore noting 

that appellant was seen in her office and that he should remain out of work until his condition 

improves. However, Dr. Moore’s notes neither provided a diagnosis in connection with the 

July 15, 2018 employment incident, nor an opinion as to causal relationship. The Board has held 

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

condition is of no probative value on the issue of causal relationship. These reports, therefore, are 

insufficient to establish appellant’s claim.11

Dr. Coulbourn indicated in a February 13, 2019 letter that appellant was seen on July 19

and 30, and August 14 and 28, 2018 for back and right hip pain. As mentioned above, the Board 

 

7 K.L., Docket No. 18-1029 (issued January 9, 2019); see 5 U.S.C. § 8101(5) (injury defined); 20 C.F.R. §§ 10.5(ee), 

10.5(q) (traumatic injury and occupational disease defined, respectively).

8 T.M., Docket No. 19-0380 (issued June 26, 2019); S.S., Docket No. 18-1488 (issued March 11, 2019).

9 T.M., id.; J.L., Docket No. 18-1804 (issued April 12, 2019).

10 M.V., Docket No. 18-0884 (issued December 28, 2018). The Board has consistently held that pain is a symptom, 

rather than a compensable medical diagnosis. See P.S., Docket No. 12-1601 (issued January 2, 2013); C.F., Docket 

No. 08-1102 (issued October 10, 2008).

11 L.B., Docket No. 18-0533 (issued August 27, 2018).
6

has held that pain is a symptom, not a specific diagnosis.

12

 For this reason, Dr. Coulbourn’s letter 

is also insufficient to meet appellant’s burden of proof.

Appellant further submitted July 19 and August 27, 2018 medical reports from nurse

practitioners Samuel and Reddish, respectively. The Board has held that medical reports signed 

solely by a nurse practitioner are of no probative value as such health care providers are not 

considered physicians as defined under FECA and are therefore not competent to provide medical 

opinions.13 Consequently, this evidence is also insufficient to establish the claim.

Appellant submitted multiple duty status reports, CA-17 forms, containing illegible 

signatures dated August 2, 14, and 27, 2018. The Board has held that a report that is unsigned or 

bears an illegible signature lacks proper identification and cannot be considered probative medical 

evidence.14 For this reason, these reports are insufficient to establish the claim.

The Board finds that appellant has not submitted rationalized, probative medical evidence 

sufficient to establish a diagnosed medical condition causally related to the accepted July 15, 2018 

employment incident.15 Appellant, therefore, 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 diagnosed 

medical condition causally related to the accepted July 15, 2018 employment incident.

 

12 Supra note 7.

13 See 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); 5 U.S.C. § 8101(2) (this subsection 

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). T.A., Docket No. 19-1030 (issued 

November 22, 2019) (nurse practitioners are not considered physicians under FECA); M.G., Docket No. 19-0918 

(issued September 20, 2019) (nurse practitioners are not considered physicians under FECA). 

14 See L.M., Docket No. 18-0473 (issued October 22, 2018); Merton J. Sills, 39 ECAB 572, 575 (1988).

15 See T.J., Docket No. 18-1500 (issued May 1, 2019); see D.S., Docket No. 18-0061 (issued May 29, 2018).
7

ORDER

IT IS HEREBY ORDERED THAT the April 17, 2019 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: December 20, 2019

Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board