United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

R.P., Appellant

and

DEPARTMENT OF VETERANS AFFAIRS, VA 

PITTSBURGH HEALTHCARE SYSTEM, 

Pittsburgh, PA, Employer

__________________________________________

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Docket No. 21-0474

Issued: April 5, 2022

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, Deputy Chief Judge

JANICE B. ASKIN, Judge

JURISDICTION

On February 8, 2021 appellant, through counsel, filed a timely appeal from a January 4, 

2021 merit decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to the 

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

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

ISSUE

The issue is whether appellant has met her burden of proof to establish a medical condition 

causally related to the accepted January 29, 2020 employment incident.

FACTUAL HISTORY

On January 30, 2020 appellant, then a 49-year-old nursing assistant, filed a traumatic injury 

claim (Form CA-1) alleging that on January 29, 2020 she injured her shoulder blades, neck, and 

right arm when she was hit by an elevator door when attempting to board an elevator while in the 

performance of duty. She noted that, following the incident, she experienced soreness between 

her shoulder blades, a stiff neck and soreness from the top of her right arm to her elbow. Appellant 

did not stop work.

OWCP received physical therapy reports dated March 4 to April 29, 2020 detailing 

appellant’s treatment for diagnoses of a lumbar strain, a contusion of the left hip, trigeminal 

neuralgia of the right side of the face and a strain of the left shoulder.

In medical reports dated January 31 to May 1, 2020, Dr. Raja Chakrapani, Board-certified 

in internal medicine, noted that appellant was hit by elevator doors on January 29, 2020. He related 

that she experienced pain in her right shoulder, hips and right elbow. Dr. Chakrapani diagnosed a 

right shoulder sprain, recommended that appellant perform light-duty work, and referred her to 

physical therapy.

In a May 20, 2020 development letter, OWCP informed 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 respond.

In an April 22, 2020 diagnostic report, Dr. Kurian Puthenpurayil, a Board-certified 

radiologist, performed an x-ray scan of appellant’s right shoulder demonstrating degenerative 

changes, but no acute fracture or malalignment. In a separate diagnostic report of even date, he 

performed an x-ray scan of her cervical spine, which revealed a reversal of a normal lordosis and 

no acute fracture.

2

5 U.S.C. § 8101 et seq.

3 The Board notes that, following the January 4, 2021 decision, OWCP received additional evidence. 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 itsfinal 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.
3

In medical reports dated from April 17 to June 12, 2020, Dr. Chakrapani noted that 

appellant was still experiencing pain in her right shoulder and hip and diagnosed a cervical sprain,

a right shoulder injury, a neck sprain and a hip injury.

In a June 15, 2020 response to OWCP’s development questionnaire, appellant asserted that 

she was stunned, light headed and unable to respond to questions for a few seconds following the 

January 29, 2020 incident. She recounted that she eventually got off of the elevator and reported 

the incident to her assistant manager. Appellant described the incident as the equivalent of being 

hit by a car. She noted that when she arrived home later on she noticed pain from her right and 

left scapula up to her neck, as well as right shoulder pain. Appellant indicated that she previously 

experienced a neck strain two years prior.

By decision dated June 22, 2020, OWCP denied appellant’s traumatic injury claim, finding 

that the medical evidence of record was insufficient to establish causal relationship between her 

diagnosed medical conditions and the accepted January 29, 2020 employment incident.

OWCP continued to receive evidence. In a March 20, 2020 diagnostic report, Dr. Stuart 

Silverman, a Board-certified neurologist, performed an electromyography (EMG) scan of 

appellant’s right upper extremity, noting that all of her findings were within normal limits.

Appellant submitted physical therapy reports dated May 4 to June 24, 2020, in which she 

continued to receive treatment for her diagnosed lumbar strain, contusion of the left hip, strain of 

the left shoulder and trigeminal neuralgia of the right side of the face.

In a June 26, 2020 medical report, Dr. Chakrapani observed that appellant was still 

experiencing neck pain and diagnosed a right-sided neck sprain. He recommended that she 

continue her physical therapy treatment.

On July 21, 2020 appellant requested an oral hearing before a representative of OWCP’s 

Branch of Hearings and Review.

In an April 15, 2020 medical report, Dr. Chakrapani observed that appellant was 

experiencing right hand swelling, neck pain and a burning sensation in her right upper extremity. 

He diagnosed a right shoulder injury.

In a July 10, 2020 duty status report (Form CA-17), Dr. Chakrapani diagnosed neck, right 

shoulder, and hip pain due to the accepted January 29, 2020 employment incident and advised that 

appellant could work with light-duty work restrictions.

In a July 28, 2020 diagnostic report, Dr. Amitesh Prasad, a Board-certified radiologist, 

performed a magnetic resonance imaging (MRI) scan of appellant’s cervical spine, demonstrating 

a disc osteophyte complex with disc protrusions most pronounced at C5-C6 and foraminal 

encroachment at C4-C5 and C5-C6.

In a September 25, 2020 diagnostic report, Dr. Jeffery Towers, a Board-certified diagnostic 

radiologist, performed an MRI scan of appellant’s lumbar spine, revealing multilevel foraminal 

encroachment.
4

Appellant submitted physical therapy reports dated July 1 to September 30, 2020 in which 

she continued to receive treatment for her diagnosed lumbar strain, contusion of the left hip, strain 

of the left shoulder and trigeminal neuralgia of the right side of the face.

A telephonic hearing was held on October 9, 2020. 

In a July 13, 2020 medical report, Dr. Benjamin Smolar, a Board-certified neurologist, 

recounted the events of the January 29, 2020 employment incident where appellant was hit by an 

elevator door and subsequently experienced pain in her left shoulder, both sides of her neck and 

her right arm. On evaluation he diagnosed paresthesias and cervical disc disorder.

In progress notes dated September 21 and 28, 2020, Dr. Patrick Smith, a Board-certified 

orthopedic surgeon, evaluated appellant for pain and symptoms she was experiencing in her neck,

back and right arm after being hit by an elevator in January 2020. He observed that an x-ray and 

MRI scan of her lumbar spine demonstrated advanced stenosis at L4-L5 with spondylolisthesis.

Dr. Smith diagnosed L4-L5 spondylolisthesis and spinal stenosis, cervical pain and ecchymosis. 

He opined that it seemed as if appellant’s conditions were aggravated by the January 29, 2020 

employment incident and that her condition was likely causing her symptoms of pain in her lower 

back and hips.

Appellant submitted additional physical therapy reports dated October 5 to 

November 30, 2020.

By decision dated January 4, 2021, the hearing representative affirmed OWCP’s June 22, 

2020 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 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 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 if an employee has sustained a traumatic injury in the performance of duty, 

OWCP begins with an analysis of whether fact of injury has been established. Fact of inju ry 

consists of two components that must be considered in conjunction with one another. The first 

4

S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59 ECAB 178 (2007); Joe D. Cameron, 41 ECAB 

153 (1989).

5 L.S., Docket No. 19-1769 (issued July 10, 2020); Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000).

6 K.M., Docket No. 15-1660 (issued September 16, 2016); L.M., Docket No. 13-1402 (issued February 7, 2014); 

DeloresC. Ellyett, 41 ECAB 992 (1990).
5

component is whether the employee actually experienced the employment incident that allegedly 

occurred.7 The second component is whether the employment incident caused a personal injury.8

Causal relationship is a medical question that requires rationalized medical opinion 

evidence to resolve the issue.9 A physician’s opinion on whether there is causal relationship 

between the diagnosed condition and the implicated employment factor(s) must be based on a 

complete factual and medical background.10 Additionally, the physician’s opinion must be 

expressed in terms of a reasonable degree of medical certainty, and must be supported by medical 

rationale explaining the nature of the relationship between the diagnosed condition and appellant’s 

specific employment factor(s).11

ANALYSIS

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

condition causally related to the accepted January 29, 2020 employment incident.

Dr. Smith, in his September 21 and 28, 2020 progress notes, evaluated appellant for pain 

and symptoms she was experiencing in her neck, back, and right arm following the accepted 

January 29, 2020 employment incident. He reviewed an x-ray and MRI scan of her lumbar spine,

which revealed advanced stenosis at L4-L5 with spondylolisthesis and diagnosed L4-L5 

spondylolisthesis and spinal stenosis, cervical pain and ecchymosis. Dr. Smith opined that it 

seemed as if appellant’s conditions were aggravated by the January 29, 2020 employment incident 

where she was hit by closing elevator doors and that her condition was likely causing her symptoms 

of pain in her lower back and hips. His opinion that it “seemed” as if her conditions were 

aggravated by the January 29, 2020 employment incident and that it was “likely” causing her 

symptoms is speculative in nature. The Board has held that medical opinions that are speculative 

or equivocal are of diminished probative value.12 Therefore, his September 21 and 28, 2020 

reports are insufficient to meet appellant’s burden of proof.13

In reports dated January 31 to July 10, 2020, Dr. Chakrapani made note of appellant’s 

complaints of pain in her right shoulder, hips, right elbow, neck, right hand swelling and a burning 

sensation in her right upper extremity following the accepted January 29, 2020 employment 

incident where she was hit by elevator doors at work. He diagnosed a right shoulder sprain, a 

7 B.P., Docket No. 16-1549 (issued January 18, 2017); Elaine Pendleton, 40 ECAB 1143 (1989).

8 M.H., Docket No. 18-1737 (issued March 13, 2019); John J. Carlone, 41 ECAB 354 (1989).

9 T.H., 59 ECAB 388, 393 (2008); Robert G. Morris, 48 ECAB 238 (1996).

10 M.V., Docket No. 18-0884 (issued December 28, 2018).

11 B.C., Docket No. 20-0221 (issued July 10, 2020); Leslie C. Moore, 52 ECAB 132 (2000).

12 Federal (FECA) Procedure Manual, Part 2 -- Claims, Developing and Evaluating Medical Evidence, Chapter 

2.810.5(c)(3); D.S., Docket No. 20-0384 (issued October 8, 2020); H.A., Docket No. 18-1455 (issued 

August 23, 2019).

13 See C.B., Docket No. 20-0464 (issued July 21, 2020).
6

cervical sprain, a neck sprain, a right shoulder injury and a hip injury. However, Dr. Chakrapani 

did not offer an opinion on the cause of these conditions. The Board has held that medical evidence 

that does not offer an opinion regarding the cause of an employment condition is of no probative 

value on the issue of causal relationship.14 Consequently, Dr. Chakrapani’s medical reports are 

also insufficient to meet appellant’s burden of proof.

Dr. Smolar, in his July 13, 2020 medical report, recounted the events of the January 29, 

2020 employment incident where appellant was hit by an elevator door and subsequently 

experienced pain in her left shoulder, both sides of her neck and her right arm. On evaluation he 

diagnosed paresthesias and cervical disc disorder, but he failed to address the issue of causal 

relationship. As noted, medical evidence that does not offer an opinion regarding the cause of an 

employment condition is of no probative value on the issue of causal relationship. 15 Consequently,

Dr. Smolar’s July 13, 2020 medical report is also insufficient to establish appellant’s claim.

Appellant submitted multiple diagnostic reports dated from March 20 to September 25, 

2020 where she underwent multiple x-ray and MRI scans of her right shoulder, and cervical and 

lumbar spine. The Board has held, however, that diagnostic test reports, standing alone, lack 

probative value on the issue of causal relationship as they do not address the relationship between 

accepted employment factors and a diagnosed condition.16 For this reason, these diagnostic reports 

are insufficient to meet appellant’s burden of proof.

The remaining evidence of record consists of numerous physical therapy reports dated 

March 4 to November 30, 2020. Certain healthcare providers such as physical therapists, nurses, 

physician assistants, and social workers are not considered physician[s] as defined under FECA.17 

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

entitlement to FECA benefits.

As appellant has not submitted rationalized medical evidence establishing a medical 

condition causally related to the accepted January 29, 2020 employment incident, 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.

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

15 Id.

16 W.M., Docket No. 19-1853 (issued May 13, 2020); L.F., Docket No. 19-1905 (issued April10, 2020).

17 5 U.S.C. § 8101(2); 20 C.F.R. § 10.5(t); see M.F., Docket No. 17-1973 (issued December 31, 2018); 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. Federal 

(FECA) Procedure Manual, Part 2 --Claims, Causal Relationship, Chapter 2.805.3a(1) (January 2013).
7

CONCLUSION

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

condition causally related to the accepted January 29, 2020 employment incident.

ORDER

IT IS HEREBY ORDERED THAT the January 4, 2021 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: April 5, 2022

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board