United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

C.E., Appellant

and

U.S. POSTAL SERVICE, SAN RAFAEL POST 

OFFICE, San Rafael, CA, Employer

__________________________________________

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Docket No. 22-0663

Issued: October 31, 2022

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

JANICE B. ASKIN, Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On March 28, 2022 appellant filed a timely appeal from a February 22, 2022 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.

2

ISSUE

The issue is whether appellant has met her burden of proof to establish disability from work 

beginning November 29, 2021 causally related to her accepted April 5, 2021 employment injury.

1

5 U.S.C. § 8101 et seq.

2 The Board notes that, following the February 22, 2022 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

FACTUAL HISTORY

On April 29, 2021 appellant, then a 53-year-old sales and services associate, filed a notice 

of recurrence (Form CA-2a) alleging that she experienced a recurrence of disability on April 5, 

2021 from an original injury of May19, 2014 under OWCP File No. xxxxxx616.3 She stopped 

work following the alleged recurrence on April 27, 2021. Appellant noted that she had returned 

to work on October 10, 2016 at limited duty and at full duty as of December 1, 2016. She further 

noted that, when she returned to work, she was initially assigned to a smaller office where she did 

not have to walk far, stand, or lift. Appellant alleged that when she returned to work in a larger 

office her pain was aggravated as she was on her feet most of the time. During the past two weeks, 

she stated that the pain was unbearable. 

On May 10, 2021 OWCP determined that appellant’s Form CA-2a was a claim for a new 

injury and, thus, a new case was created under OWCP File No. xxxxxx541. It converted 

appellant’s Form CA-2a to a new claim for occupational disease (Form CA-2) with a date of injury 

of April 5, 2021.

OWCP received several reports dated June 2, 2021 from Dr. Zilue Tang, Board-certified 

in occupational medicine. He diagnosed left knee joint pain and osteoarthritis of appellant’s left 

knee and noted that the underlying cause of appellant’s symptoms was an old work-related 

condition. Dr. Tang related that appellant had a history of left knee surgeries in 2014 and2015 and 

that, since April, appellant had to perform a lot of walking and standing on her feet after moving 

to work in a bigger office. He stated that appellant was to be placed on modified duty from June 2 

through 23, 2021 with work restrictions of walking no more than 20 cumulative minutes per hour. 

On June 9, 2021 OWCP accepted appellant’s claim for unilateral primary osteoarthritis of 

the left knee.

In a report dated June 23, 2021, Dr. Tang diagnosed left knee joint pain and osteoarthritis 

of the left knee with a history of anterior cruciate ligament (ACL) tear reconstruction in 2015. He 

continued appellant’s modified duty through July 14, 2021, noting that if modified activity was 

not accommodated by the employing establishment, appellant would be considered temporarily 

and totally disabled from her regular work. 

In a work status report dated July 9, 2021, Dr. Tang diagnosed left knee joint pain and 

osteoarthritis of the left knee with a history of ACL tear reconstruction. He placed appellant on 

modified duty from June 23 through July 14, 2021, with work restrictions of walking no more than 

20 consecutive minutes per hour. 

In a progress report dated July 14, 2021, Dr. Tang diagnosed left knee joint pain and 

osteoarthritis of the left knee with a history of ACL tear reconstruction. He continued appellant’s 

3

In OWCP File No. xxxxxx616, appellant filed a traumatic injury claim (Form CA-1) alleging that she strained her 

left leg when she slid and fell from the second step of a stairway. OWCP accepted this claim for left knee contusion, 

derangement of the left medial meniscus, old disruption of the left anterior cruciate ligament, and internal derangement 

of the left knee. 
3

modified work from July 14 through 28, 2021, with the same work restrictions. On July 28, 2021

Dr. Tang extended these restrictions through August 11, 2021.

In a progress report dated August 10, 2021, Dr. Joseph Centeno, a Board-certified general 

surgeon, diagnosed status post left knee ACL reconstruction and chronic pain syndrome. In a work 

status note dated August 25, 2021, he recommended that appellant return to work at limited duty 

with restrictions of walking no more than 20 minutes. Dr. Centenoreiterated appellant’s diagnoses 

in a progress report of August 26, 2021. Appellant informed Dr. Centeno that she was working 

light duty at that time, but that, due to lack of staffing, she performed tasks outside of her work 

restrictions. Dr. Centeno recommended an update of her work restrictions to include one day off 

per week as needed if appellant had severe left knee pain and to continue the previous work 

restrictions as well.

OWCP paid appellant intermittent wage-loss compensation on the supplemental rolls from 

August 26 through November 2, 2021. 

On September 28, 2021 Dr. Centeno diagnosed status post left knee ACL reconstruction 

and chronic pain syndrome. He continued appellant’s work restrictions. 

Appellant submitted a work status report dated November 2, 2021 by Benjamin Hubbard, 

a physician assistant.

In a progress report dated November 2, 2021, Dr. Centeno rendered the same diagnoses 

and noted that she continued to be symptomatic without significant change. He continued 

appellant’s work restrictions. Appellant told Dr. Centeno that, while she attempted to follow her

work restrictions, it was difficult to follow them with exactness due to low staffing at the 

employing establishment.

On December 23, 2021 appellant filed a claim for compensation (Form CA-7) for disability 

from work for the period November 29 through December 15, 2021. 

OWCP continued to receive medical evidence. In a report dated November 30, 2021,

Dr. Centeno diagnosed status post left knee ACL reconstruction in 2014. Appellant informed

Dr. Centeno that two days prior, she was performing her home exercise program on her exercise 

bike when she felt as though she injured her left knee, which had become swollen. Dr. Centeno

recommended that appellant remain off work for the next two weeks to rest and recover. 

In a development letter dated December 29, 2021, OWCP requested that appellant submit 

medical evidence to support disability after November 29, 2021 causally related to the accepted 

employment injury. It afforded her 30 days to submit the requested evidence.

In a progress report dated December 16, 2021, Dr. Centeno diagnosed status post ACL 

reconstruction on the left knee in 2014 and chronic pain syndrome. He noted that appellant 

planned to file a compensation claim for her lower back, which had begun to bother her. 

Dr. Centeno speculated that her back issues could be related to an abnormal gait due to her left 

knee condition.
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Appellant continued to submit CA-7 forms covering the period December 16, 2021 through 

February 11, 2022. She indicated in time analysis forms (Form CA-7a) that her claimed 

compensation was for temporary disability. 

Appellant submitted a work status note dated December 16, 2021, signed by Kate 

Donnelly, a physician assistant. She also submitted progress reports dated January 5 and 12, 2022, 

signed by Mr. Hubbard and Ms. Donnelly, respectively. 

In a work status note dated January 5, 2022, Dr. Teodoro Nissen, an orthopedic surgeon, 

recommended that appellant be off work. However, he also stated that appellant should have a 

work restriction of no walking or standing more than 20 minutes. 

On February 1, 2022 Cynthia T. Keane, a nurse practitioner, recommended that appellant 

return to limited duty with a work restriction of walking or standing more than 20 minutes.

By decision dated February 22, 2022, OWCP denied appellant’s claim for compensation 

for disability compensation for the period commencing November 29, 2021. 

LEGAL PRECEDENT

An employee seeking benefits under FECA has the burden of proof to establish the 

essential elements of his or her claim, including that any disability or specific condition for which 

compensation is claimed is causally related to the employment injury. 4 For each period of 

disability claimed, the employee has the burden of proof to establish that he or she was disabled 

from work as a result of the accepted employment injury.5 Whether a particular injury causes an 

employee to become disabled from work, and the duration of that disability, are medical issues 

that must be proven by a preponderance of probative and reliable medical opinion evidence.6

Under FECA the term “disability” means the incapacity, because of an employment injury, 

to earn the wages that the employee was receiving at the time of injury.7 Disability is, thus, not 

synonymous with physical impairment, which may or may not result in an incapacity to earn 

wages. An employee who has a physical impairment causally related to a federa l employment 

injury, but who nevertheless has the capacity to earn the wages he or she was receiving at the time 

of injury, has no disability as that term is used in FECA.8

The Board will not require OWCP to pay compensation for disability in the absence of 

medical evidence directly addressing the specific dates of disability for which compensation is 

4

See D.S., Docket No. 20-0638 (issued November 17, 2020); F.H., Docket No. 18-0160 (issued August23, 2019); 

C.R., Docket No. 18-1805 (issued May 10, 2019); Kathryn Haggerty, 45 ECAB 383 (1994); Elaine Pendleton, 40 

ECAB 1143 (1989).

5 B.O., Docket No. 19-0392 (issued July 12, 2019); D.W., Docket No. 18-0644 (issued November 15, 2018).

6

20 C.F.R. § 10.5(f); B.O., id.; N.M., Docket No. 18-0939 (issued December 6, 2018).

7

Id. at § 10.5(f); see B.K., Docket No. 18-0386 (issued September 14, 2018).

8

Id.
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claimed. To do so, would essentially allow an employee to self-certify their disability and 

entitlement to compensation.9

ANALYSIS

The Board finds that appellant has not met her burden of proof to establish disability from 

work beginning November 29, 2021 causally related to her accepted April 5, 2021 employment 

injury.

Prior to November 29 2021, the evidence of record establishes that appellant was working 

modified duty, with restrictions regarding limited walking provided by Dr. Tang and Dr. Centeno. 

In a report dated November 30, 2021, Dr. Centeno diagnosed status post left knee ACL 

reconstruction in 2014. Appellant apprised Dr. Centeno that two days prior, she was performing 

her home exercise program on her exercise bike when she felt as though she injured her left knee, 

which had become swollen. Dr. Centenorecommended that appellant remain off work for the next 

two weeks to rest and recover. However, he did not explain, with rationale, how or why appellant 

was unable to perform her modified work after November 29, 2021 due to the effects of her 

accepted conditions. The Board has held that a report is of limited probative value regarding causal 

relationship if it does not contain medical rationale explaining how a given medical 

condition/period of disability has an employment-related cause.10 For these reasons, the Board 

finds that Dr. Centeno’s report was insufficient to establish appellant’s disability claim.

OWCP also received a progress report dated December 16, 2021 from Dr. Centeno. 

However, in this report, Dr. Centeno did not address whether appellant was totally disabled from 

work during the claimed periods due to the accepted employment injury. Medical evidence that 

does not offer an opinion regarding the cause of an employee’s condition or disability is of no

probative value on the issue of causal relationship.11 As such, this report is of no probative value,

with regard to the claimed period of disability.12

On January 5, 2022 Dr. Nissen recommended that appellant remain off work. However, 

he also noted that appellant had a work restriction of no walking or standing more than 20 minutes. 

This report from Dr. Nissen did not offer an opinion as to whether appellant’s accepted

employment injury was the cause of her disability. The Board has held that medical evidence that 

does not provide an opinion regarding whether a period of disability is due to an accepted 

9 A.W., Docket No. 18-0589 (issued May 14, 2019).

10 See T.S., Docket No. 20-1229 (issued August 6, 2021); S.K., Docket No. 19-0272 (issued July 21, 2020); T.T., 

Docket No. 18-1054 (issued April8, 2020); Y.D., Docket No. 16-1896 (issued February 10, 2017).

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

also Charles H. Tomaszewski, 39 ECAB 461 (1988).

12 See Y.D., Docket No. 20-0097 (issued August25, 2020); J.T., Docket No. 19-1813 (issued April14, 2020).
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employment injury is of no probative value and, thus, is insufficient to establish a claim. 13 

Consequently, Dr. Nissen’s disability notes are insufficient to meet appellant’s burden of proof.14

Appellant also submitted work status notes dated December 16, 2021 and January 5 

and 12, 2022, by physician assistants. OWCP also received a February1, 2022 report from a nurse

practitioner. These reports, however, are of no probative value as physician assistants are not 

considered physicians as defined under FECA.15

As appellant has not submitted rationalized medical evidence establishing causal 

relationship between her claimed periods of disability and the accepted April 5, 2021 employment 

injury, the Board finds that she has not met her burden of proof.

CONCLUSION

The Board finds that appellant has not met her burden of proof to establish disability from 

work beginning November 29, 2021 causally related to her accepted April 5, 2021 employment 

injury.

13 See S.D., Docket No. 20-1255 (issued February 3, 2021); L.L., Docket No. 19-1794 (issued October 2, 2020); 

C.R., Docket No. 19-1427 (issued January 3, 2020); L.B., supra note 11; D.K., supra note 11. 

14 Id.

15 Section 8102(2) of FECA provides that the term physician includes 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 Federal (FECA) Procedure Manual, Part 2 -- Claims, 

Causal Relationship, Chapter 2.805.3a(1) (January 2013); DavidP. 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). See also K.C., Docket No. 19-0834 (issued October 28, 2019) and E.T., Docket No. 17-0265 (issued 

May 25, 2018) (in which the Board held that physician assistants are not considered physicians under FECA); B.V., 

Docket No. 21-0742 (issued December 14, 2021) (nurse practitioners are not considered physicians as defined under 

FECA).
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ORDER

IT IS HEREBY ORDERED THAT the February 22, 2022 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: October 31, 2022

Washington, DC

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board