United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

B.S., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE,

Oklahoma City, OK, Employer

__________________________________________

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Docket No. 22-0918

Issued: August 29, 2022

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

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 May 31, 2022 appellant filed a timely appeal from an April 7, 2022 merit decision of

the Office of Workers’ Compensation Programs (OWCP). 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.3

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 services 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.

3 The Board notes that, following the April7, 2022,decision, appellant submitted additional evidence to OWCP. 

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 notbefore 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

ISSUE

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

condition causally related to the accepted November 27, 2021 employment incident.

FACTUAL HISTORY

On December 21, 2021 appellant, then a 74-year-old rural carrier associate, filed a

traumatic injury claim (Form CA-1) alleging that on November 27, 2021 he tore his left rotator

cuff when he tripped on a tub and fell while carrying two trays of mail while in the performance

of duty.4 He stopped work on November 27, 2021.

In a December 9, 2021 development letter, OWCP informed appellant of the deficiencies

in his claim. It advised him of the type of factual and medical evidence needed to establish his

claim and provided a questionnaire for his completion. OWCP afforded appellant 30 days to

respond.

Appellant submitted a November 27, 2021 note from Jeremiah Ryan Rodgers, a physician

assistant, indicating that he was treated in the emergency room that day. Mr. Rogers released

appellant to light-duty work with restrictions. A left shoulder x-ray scan of even date revealed

degenerative changes about the glenohumeral and acromioclavicular (AC) joints, with no acute

fracture or dislocation.

A follow-up x-ray of the left shoulder dated December 16, 2021 confirmed moderate

degenerative changes of the AC joint and mild degeneration of the glenohumeral joint with no

visible fracture or acute injury.

OWCP also received unsigned notes dated December 28, 2021, which noted a

November 21, 2021 date of injury and that appellant continued to present with leftshoulder pain. 

It further indicated that a magnetic resonance imaging (MRI) scan was scheduled for

December 30, 2021.

By decision dated January 14, 2022, OWCP accepted that the November 27, 2021

employment incident occurred as alleged. However, it denied appellant’s claim, finding that he

had not submitted evidence of a diagnosed medical condition in connection with the accepted

employmentincident. Thus, OWCPconcluded thatthe requirements had notbeen metto establish

an injury as defined by FECA.

On February 16, 2022 appellant requested reconsideration of OWCP’s January 14, 2022

decision. 

4 The record reflects that appellant initially filed an occupationaldisease claim (Form CA-2) on December 3, 2021 

alleging a traumatic injury occurring on November 27, 2021. OWCP properly adjudicated the claim as a traumatic 

injury. 
3

OWCP received an undated and unsigned MRI scan report of the left shoulder, which

demonstrated a full thickness tear of the supraspinatus tendon, with infraspinatus and subscapular

tendinosis, and moderate AC joint osteoarthrosis.

In a statement dated February 3, 2022, attached to a copy of his February 16, 2022 request

for reconsideration, appellant explained that, following the November 27, 2021 employment

incident, he was treated in the emergency room. He noted that, thereafter, he was seen by

Dr. Spencer H. Guinn, Board-certified in orthopedic surgery and sports medicine, on

January 26, 2022. Appellant asserted that findings following that visit established a correlation

between his diagnosed conditions and the accepted employment incident.

In a report dated January 26, 2022, Dr. Guinn noted that appellant presented with

complaints of left shoulder pain, which he described as waxing and waning with a burning

sensation. He related that appellant was injured at work on November 27, 2021 when he fell

forward onto a counter while carrying a tray of mail. Appellant described feeling an instant snap

and pain in his shoulder radiating into his elbow. Dr. Guinn further noted that appellant had no

prior left shoulder injury. On physical examination he observed profound weakness and

tenderness anteriorly. Dr. Guinn reviewed x-rays performed that day and an MRI scan of the left

shoulder noting that it revealed a full thickness tear of the supraspinatus, moderate arthritis of the

AC joint and a tear of the long heard of the biceps tendon. He diagnosed an acute large full

thickness work-related leftrotator cufftear and recommended an arthroscopywith rotator cuff tear

repair.

By decision dated April 7, 2022, OWCP modified its prior decision to find that the

evidence of record was sufficient to establish a diagnosed medical condition in connection with

the accepted November 27, 2021 employmentincident; however, the claim remained denied asthe

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

leftshoulder condition and the accepted employment incident.

LEGAL PRECEDENT

An employee seeking benefits under FECA5 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 of FECA, that the claim was timely filed within the applicable time

limitation of FECA6, 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 the

5

Supra note 1.

6 F H., Docket No.18-0869 (issued January 29, 2020); J.P., Docket No. 19-0129 (issued December 13, 2019); 

Joe D. Cameron, 41 ECAB 153 (1989).
4

employment injury.7 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.8

To determine whether a federal employee has sustained a traumatic injury in the

performance of duty, itfirstmust be determined whetherfact of injury has beenestablished. There

are two components involved in establishing fact of injury. The first component is that the

employee must submit sufficient evidence to establish that he or she actually experienced the

employment incident at the time and place, and in the manner alleged. The second component is

whether the employment incident caused a personal injury.

9

The evidence required to establish causal relationship is rationalized medical opinion

evidence.10 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 medicalrationale explainingthe nature of the relationship between the diagnosedconditionand

specific employment incident identified by the employee.11

ANALYSIS

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

condition causally related to the accepted November 27, 2021 employment incident.

In his January 26, 2022 report, Dr. Guinn diagnosed a large full thickness left rotator cuff

tear as a result of the accepted November 27, 2021 employment incident. While his report was

supportive of causal relationship, he did not provide an explanation as to how appellant’s 

diagnosed medical condition was caused or aggravated by the accepted employment incident. The 

Board has held that medical reports that lack a rationalized medical opinion regarding causal 

relationship are of diminished probative value.12 Thus, Dr. Guinn’s January 26, 2022 report is

insufficient to meet appellant’s burden of proof. 

OWCP also received a November 27, 2021 note from Mr. Rodgers, a physician assistant. 

The Board has held, however, that medical reports signed solely by a physician assistant, registered 

nurse, or medical assistant are of no probative value as such healthcare providers are not considered 

7 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).

8 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).

9 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). 

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

Robert G. Morris, 48 ECAB 238 (1996).

11 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).

12 See A.C., Docket No. 20-1510 (issued April23, 2021); J.P., Docket No. 20-0381 (issued July 28, 2020); R.L., 

Docket No. 20-0284 (issued June 30, 2020).
5

physicians as defined under FECA and are, therefore, not competent to provide medical opinions. 

As such, the November 27, 2021note fromMr. Rodgers is also insufficient to establish appellant’s 

claim.

13

Appellant submitted x-rays dated November 27, 2021 and December 16, 2021, as well as

an undated and unsigned MRI scan report. However, the Board has held reports of diagnostic

tests, standing alone, lack probative value as they do not provide an opinion on causal relationship

between an employment incident and a diagnosed condition.14 

The remaining evidence of record consists of unsigned notes dated December 28, 2021. 

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 as the author cannot be 

identified as a physician.15 These notes are, therefore, insufficient to establish appellant’s claim.

As appellant has not submitted rationalized medical evidence sufficient to establish that his 

diagnosed left shoulder condition is causally related to the accepted November 27, 2021

employment incident, the Board finds that he 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 leftshoulder

condition causally related to the accepted November 27, 2021 employment incident.

13 Section 8101(2) provides that under FECA the term physician includes surgeons, podiatrists, dentists, clinical 

psychologists, optometrists, chiropractors, and osteopathic practitioners within the scope of their practice as defined 

by the applicable 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 E.T., Docket No. 17-0265 (issued May 25, 2018) (physician assistants are not 

considered physicians under FECA).

14 See B.R., Docket No. 21-1109 (issued December 28, 2021); J.K., Docket No. 20-0591 (issued August12, 2020);

A.B., Docket No. 17-0301 (issued May 19, 2017).

15 R.C., Docket No. 20-1525 (issued June 8, 2021); I.M., Docket No. 19-1038 (issued January 23, 2020); T.O., 

Docket No. 19-1291 (issued December 11, 2019); MertonJ. Sills, 39 ECAB 572, 575 (1988).
6

ORDER

IT IS HEREBY ORDERED THAT the April 7, 2022 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: August 29, 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