United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

S.B., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE,

San Francisco, CA, Employer

__________________________________________

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Docket No. 21-0683

Issued: December 16, 2021

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 March 24, 2021 appellant filed a timely appeal from a December 8, 2020 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 has met her burden of proof to establish a right shoulder 

condition causally related to the accepted March 14, 2020 employment incident. 

1 The Board notes that, following the December 8, 2020 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

5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY

On April 17, 2020 appellant, then a 53-year-old city carrier assistant, filed a traumatic 

injury claim (Form CA-1) alleging that on March 14, 2020 she sustained a shoulder sprain, 

shoulder dislocation, and frozen shoulder when carrying a mail satchel on her right shoulder while 

in the performance of duty. On the reverse side of the claim form appellant’s supervisor 

acknowledged thatshe was injured in the performance of duty.

In support of her claim, appellant submitted literature on how to care for a shoulder sprain 

and frozen shoulder exercises.

Appellant also submitted an unsigned letter dated March 25, 2020 from an emergency 

department, which noted that she was seen by a provider and could return to work in three days.

In a development letter dated April 21, 2020, OWCPinformed appellant of the deficiencies 

of 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 the necessary 

evidence.

In a letter dated April 28, 2020, the employing establishment controverted appellant’s 

claim, explaining that she had not worked from December 7, 2019 through March 13, 2020 and 

that her alleged injury occurred on the day she returned to work. Appellant, however, did not 

report her injury until April 17, 2020. The employing establishment also noted that she filed an 

occupationaldisease claim (Form CA-2) on March 23, 2020 for a shoulder sprain,which she stated 

occurred on March 13, 2020.

By decision dated May 26, 2020, OWCP denied appellant’s claim as the evidence 

submitted was insufficient to establish that the incident occurred, as alleged. It concluded, 

therefore, that the requirements had not been met to establish an injury as defined by FECA.

Appellant submitted a letter dated May 5, 2020 from Dr. Milliardaire Syverain, an internal 

medicine specialist. The letter was partially legible, but noted a right shoulder and right foot injury 

at work.

On June 10, 2020 appellant timely requested a telephonic hearing before a representative 

of OWCP’s Branch of Hearings and Review, which was held on October 6, 2020. The hearing 

representative afforded appellant 30 days to submit additional evidence.

In response, appellant submitted a medical note dated July 23, 2020 from Michelle 

Buchholz, a family nurse practitioner. Ms. Buchholz related that appellant had experienced 

intense pain in her right shoulder while carrying a postal bag in March. She indicated that appellant 

may have sustained a torn rotator cuff.

OWCP received a medical note dated August 24, 2020 from Dr. Alma Sanchez, a family 

medicine specialist. Dr. Sanchez noted that appellant had pain in her right shoulder radiating down 

her arm and that she had reported carrying mail on her right shoulder. She related that appellant 

had decreased range of motion of the right shoulder. Dr. Sanchez noted possible diagnoses as 

frozen shoulder or rotator cuff injury.
3

In a progress note dated October 8, 2020, Dr. Sanchez assessed right shoulder pain and 

related that it remained unchanged. She also stated that an x-ray of appellant’s right shoulder 

revealed normal joint findings, but with possible degenerative changes of the humeral head.

By decision dated December 8, 2020, OWCP’s hearing representative modified OWCP’s 

May 26, 2020 decision and found that the March 14, 2020 employment incident occurred, as 

alleged, but denied appellant’s claim, finding that causal relationship had not been established 

between her right shoulder pathology and the accepted 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 that the individual is an employee of the United 

States within the meaning FECA, that the claim was timely filed within the applicable time 

limitation period 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 must first be determined whether fact of injury has been established. There 

are two components involved in establishing fact of injury. The first component to be established 

is that 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. The second component is 

whether the employment incident caused a personal injury and can be established only by medical 

evidence.7

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

condition and an employment incident is rationalized medical opinion evidence. 8 The opinion of 

the physician must be based on a complete factual and medical background of the employee, must 

be one of reasonable medical certainty, and must be supported by medical rationale explaining the 

3

Id.

4 F.H., Docket No. 18-0869 (issued January 29, 2020); J.P., Docket No. 19-0129 (issued April26, 2019); Joe D. 

Cameron, 41 ECAB 153 (1989).

5 L.C., Docket No. 19-1301 (issued January 29, 2020); J.H., Docket No. 18-1637 (issued January 29, 2020); 

James E. Chadden, Sr., 40 ECAB 312 (1988).

6 P.A., Docket No. 18-0559 (issued January 29, 2020); K.M., Docket No. 15-1660 (issued September 16, 2016); 

DeloresC. Ellyett, 41 ECAB 992 (1990).

7 T.H., Docket No. 19-0599 (issued January 28, 2020); K.L., Docket No. 18-1029 (issued January 9, 2019); John J. 

Carlone, 41 ECAB 354 (1989).

8

S.S., Docket No. 19-0688 (issued January 24, 2020); A.M., Docket No. 18-1748 (issued April24, 2019); RobertG. 

Morris, 48 ECAB 238 (1996).
4

nature of the relationship between the diagnosed condition and specific employment factors 

identified by the employee.9

ANALYSIS

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

condition causally related to the accepted March 14, 2020 employment incident. 

In a May 5, 2020 letter, Dr. Syverain related that appellant had sustained a right shoulder 

injury at work. As this report lacked medical rationale establishing causal relationship, it is

insufficient to establish appellant’s claim.10

Appellant submitted medical notes dated August 24 and October 8, 2020 from

Dr. Sanchez, which related that appellant was seen forright shoulder pain. In her August 24, 2020 

report, Dr. Sanchez noted possible diagnosis of frozen shoulder or rotator cuff tear. In her 

October 8, 2020 report, she assessed right shoulder pain and noted possible degenerative changes 

of the humeral head. However, Dr. Sanchez did not offer an opinion on 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 relationship11 As such, these 

reports from Dr. Sanchez were insufficient to establish a diagnosed right shoulder condition 

causally related to the accepted employment incident.

Appellant also submitted a progress note dated July 23, 2020 from Ms. Buchholz, a family 

nurse practitioner. Certain healthcare providers such as physician assistants, nurse practitioners, 

and physical therapists are not considered physicians as defined under FECA. 12 Consequently,

Ms. Buchholz’ report will not suffice for purposes of establishing entitlement to FECA benefits.13

OWCP also received a letter dated March 25, 2020 from an emergency department which 

was unsigned. The Board has held that reports that are unsigned or bear an illegible signature 

cannot be considered probative medical evidence as the author cannot be identified as a 

9 T.L., Docket No. 18-0778 (issued January 22, 2020); Y.S., Docket No. 18-0366 (issued January 22, 2020); 

Victor J. Woodhams, 41 ECAB 345, 352 (1989).

10 P.C., Docket No. 18-0167 (issued May 7, 2019).

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

12 5 U.S.C. § 8101(2) 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,” 

20 C.F.R. § 10.5(t). See Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 

2.805.3a(1) (January 2013); see also M.F., Docket No. 19-1573 (issued March16, 2020); N.B., Docket No. 19-0221 

(issued July 15, 2019); 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).

13 See M.C., Docket No. 19-1074 (issued June 12, 2020) (nurse practitioners are not considered physicians under 

FECA).
5

physician.14 Therefore, this document has no probative value and is insufficient to establish the 

claim.

Finally, OWCP received literature from the appellant on how to care for a shoulder sprain 

and frozen shoulder exercises. The Board has, however, long held that excerpts from publications 

have little probative value in resolving medical questions unless a physician establishes the 

applicability of the general medical principle discussed in the article to the specific factual situation 

in the case.15

As there is no medical evidence of record establishing a right shoulder condition causally 

related to the accepted March 14, 2020 employment incident, the Board finds that appellant 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 a right shoulder 

condition causally related to the accepted March 14, 2020 employment incident. 

14 C.S., Docket No. 20-1354 (issued January 29, 2021); D.T., Docket No. 20-0685 (issued October 8, 2020); 

Merton J. Sills, 39 ECAB 572, 575 (1988).

15 T.S.,Docket No. 18-1518 (issued April17, 2019); W.C. (R.C.), Docket No. 18-0531 (issued November 1, 2018); 

K.U., Docket No. 15-1771 (issued August26, 2016); Roger D. Payne, 55 ECAB 535 (2004).
6

ORDER

IT IS HEREBY ORDERED THAT the December 8, 2020 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: December 16, 2021

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