United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

M.O., Appellant

and

DEPARTMENT OF THE ARMY, BROOKE 

ARMY MEDICAL CENTER, Houston, TX, 

Employer

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Docket No. 21-1068

Issued: March 1, 2022

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

JANICE B. ASKIN, Judge

PATRICIA H. FITZGERALD, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On June 28, 2021 appellant filed a timely appeal from a May 28, 2021 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.

ISSUE

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

condition causally related to the accepted October 9, 2020 employment incident. 

FACTUAL HISTORY

On April 12, 2021 appellant, then a 57-year-old practical nurse, filed a traumatic injury 

claim (Form CA-1) alleging that on October 9, 2020 a maintenance worker ran over her right foot 

1

5 U.S.C. § 8101 et seq.
2

with a cart, which caused pain and swelling in her right foot as well as knee pain. On the reverse 

side of the claim form, appellant’s supervisor indicated that she was injured in the performance of 

duty. Appellant did not stop work. 

In support of her claim, appellant submitted a medical report dated November 3, 2020 from

Dr. Melany A. Shearrer, a family medicine specialist. Dr. Shearrer related that appellant was seen 

for right foot pain and a small lump on the top of her foot, which began one month prior when a 

maintenance cart hit the top of her foot. 

In reports dated March 10 and 12, 2021, Dr. Tamara Moseley, a podiatrist, related that a 

cart ran over appellant’s foot in November 2020 and she noted that appellant had complaints of 

right foot pain, swelling, and paresthesia. In the March 12, 2021 note, she related that x-rays of 

appellant’s foot were negative for fracture and diagnosed right foot pain. 

In a March 11, 2021 report, Dr. Bhavna Lalvani, a family medicine specialist, related that 

appellant was seen for right knee pain, which appellant believed resulted from overcompensating 

from a right foot injury in November 2020. 

On March 30, 2021 a physical therapist requested a consultation for a provisional diagnosis 

of right knee unilateral primary osteoarthritis. 

OWCP received a letter dated April 8, 2021 from appellant’s co-worker, M.R., and a 

separate letter from her co-worker, T.V. Both co-workersstated that they witnessed a maintenance

cart run over appellant’s right foot in October 2020. M.R. also related that appellant stated that 

she was in pain and held her right leg and foot following the incident. 

In a development letter dated April 26, 2021, OWCP informed appellant of the deficiencies 

in her claim. It noted 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 report dated April 27, 2021, Matthew Randel, a physical therapist, related that 

appellant presented with signs and symptoms commonly associated with right foot pain , likely due 

to nerve and soft tissue injury. 

Appellant submitted a response to OWCP’s development questionnaire dated May 5, 2021. 

She attested that she told her supervisor of her injury three or four weeks after it occurred as she 

was still in pain. Appellant stated that her supervisor initially indicated that it was too late to file 

a claim. 

By decision dated May 28, 2021, OWCP accepted that the October 9, 2020 employment 

incident occurred, as alleged; however the claim was denied as she had not submitted medical 

evidence containing a medical diagnosis in connection with her accepted employment incident. It 

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

FECA. 
3

LEGAL PRECEDENT

An employee seeking benefits under FECA2 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,3that 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.4 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.5

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

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

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 and can be established only by medical 

evidence.6

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

condition and an employment incident is rationalized medical opinion evidence. 7 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 

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

identified by the employee.8

2

Id.

3 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).

4 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).

5 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).

6 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).

7

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).

8 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).
4

ANALYSIS

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

medical condition causally related to the accepted October 9, 2020 employment incident.

In support of her claim, appellant submitted a medical report dated November 3, 2020 from

Dr. Shearrer, which related that appellant was seen for right foot pain. Similarly, OWCP received 

a medical report dated March 11, 2021 from Dr. Lalvani, which stated that appellant was seen for

right knee pain. The Board has held that pain is a symptom and not a compensable medical 

diagnosis.9 As these reports did not provide a firm diagnosis causally related to the acc epted 

employment incident, they are insufficient to establish appellant’s claim. 

OWCP also received reports dated March 10 and 12, 2021 fromDr. Moseley, which related 

that appellant had right foot pain, swelling, and paresthesia. As with pain,10 swelling,

11 and 

numbness12 are also symptoms of a medical condition, not diagnoses. For this reason,

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

Appellant also submitted were reports from physical therapists. Certain healthcare 

providers such as physician assistants, nurse practitioners, and physical therapists are not 

considered physicians as defined under FECA.13 Their opinions are therefore not considered 

competent medical evidence.14 Consequently, this evidence will not suffice for purposes of 

establishing entitlement to FECA benefits.15

As there is no medical evidence of record establishing a diagnosed medical condition 

causally related to the accepted October 9, 2020 employment incident, the Board finds that 

appellant has not met her burden of proof. 

9

See S.L., Docket No. 19-1536 (issued June26, 2020); D.Y., Docket No. 20-0112 (issued June 25, 2020).

10 Supra note 9. 

11 M.C.,Docket No. 17-0024 (issued March 22, 2018). 

12 See LeonardoG. Cobero,Docket No. 99-2489 (issued June1, 2001). 

13 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 also 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 March 16, 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).

14 M.T., Docket No. 21-0783 (issued December 27, 2021). 

15 See M.C., Docket No. 19-1074 (issued June 12, 2020). 
5

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 diagnosed 

medical condition causally related to the accepted October 9, 2020 employment incident.

ORDER

IT IS HEREBY ORDERED THAT the May 28, 2021 decision of the Office of Workers’

Compensation Programs is affirmed. 

Issued: March 1, 2022

Washington, DC

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board