United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

S.K., Appellant

and

U.S. POSTAL SERVICE, SAINT LOUIS POST 

OFFICE, St. Louis, MO, Employer

__________________________________________

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Docket No. 22-0636

Issued: October 27, 2022

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On March 16, 2022 appellant filed a timely appeal from a December 16, 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.2

ISSUE

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

condition in connection with the accepted October 29, 2021 employment incident.

1

5 U.S.C. § 8101 et seq.

2 The Board notes that, following the December 16, 2021 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 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 November 4, 2021appellant, then a 30-year-old city carrier assistant 1, filed a traumatic 

injury claim (Form CA-1) alleging that on October 29, 2021 he hyperextended his left calf muscle 

when his vehicle was rear ended by a truck while in the performance of duty. He did not 

immediately stop work.

OWCP received discharge instructions from an emergency department dated October 29, 

2021 from a provider whose signature was illegible, who released appellant to work with walking 

restricted to 50 feet once an hour.

In a November 10, 2021 development letter, OWCP informed appellant of the deficiencies 

of his claim. It explained the type of factual and medical evidence needed and provided a 

questionnaire for his completion. OWCP afforded him 30 days to submit the necessary evidence.

An October 29, 2021 accident report noted that appellant was driving an employing 

establishment life long vehicle (LLV) and was rear ended by a pickup truck causing appellant’s 

LLV to rear end the vehicle in front of him. The officer noted visible damage to the rear and front 

end of appellant’s vehicle including the windshield. Appellant requested to receive treatment by 

medical personnel at the employing establishment.

On October 29, 2021 Dr. Curtis L. Horstman, an osteopath Board-certified in family 

medicine, treated appellant for a head and left lower extremity injury. Appellant reported sitting 

in a parked postal vehicle when he was rear ended by another vehicle. At the time of the accident,

he was loosely wearing a seatbelt with his leg crossed. Appellant complained of discomfort of the 

lower left leg and a bump on the front of his forehead. He noted being ambulatory after the 

accident but had increasing pain and sought treatment in the emergency room. Dr. Horstman noted 

his clinical impression of a motor vehicle accident and discharged appellant home in stable 

condition.

A computerized tomography (CT) scan of the head dated October 29, 2021 revealed no 

acute intracranial abnormality. An x-ray of the left tibia fibula revealed no fractures. An x-ray of 

the cervical spine revealed no fractures.

On November 4, 2021 Elton Hoerning, a nurse practitioner, treated appellant for a left leg 

injury. Appellant reported being rear ended in his postal truck while he was at a stop. He stated 

that he was thrown forward somewhat violently and injured his left lower leg and possibly hit his 

head. Findings on physical examination revealed mild left lower leg pain to palpation in the

posterior midline, mild soft tissue swelling of the left lower leg, increased pain with passive 

dorsiflexion of the ankle, and moderate antalgic gait. Mr. Hoerning diagnosed left lower leg pain, 

most likely calf strain, and returned appellant to work subject to restrictions. He treated appellant 

in follow up on November 10, 2021, who reported improvement in his symptoms and an ability to 

ambulate short distances. Findings on physical examination revealed minimal swelling of the left 

lower leg and mild discomfort to palpation along the posterior and lateral portions of the left lower 

leg in the calf. Mr. Hoerning diagnosed left lower leg pain, most likely calf strain. On 

November 23, 2021 appellant reported continuing improvement in his symptoms. Mr. Hoerning 
3

diagnosed left lower leg pain status post motor vehicle accident and returned appellant to full-duty

work.

In response to the development letter, appellant submitted a November 13, 2021 statement 

and noted that the automobile accident occurred on his regular route. He indicated that at the time 

of the accident he was on his regularly assigned route performing his regularly assigned duties.

By decision dated December 16, 2021, OWCP accepted that the October 29, 2021

employment incident occurred as alleged. However, it denied appellant’s traumatic injury claim, 

finding that he had not submitted medical evidence containing a diagnosis in connection with the 

accepted employment incident. OWCP concluded, therefore, that the requirements had not been 

met to establish an injury as defined under FECA.

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 of FECA, that the claim was timely filed within the applicable time 

limitation 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 first must be determined whether fact of injury has been established. First, 

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. Second, the employee must 

submit sufficient evidence to establish that the employment incident caused a personal injury. 7

The medical evidence required to establish a causal relationship 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 

3

Id.

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

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.J., Docket No. 19-0461 (issued August 11, 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).
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by medical rationale explaining the nature of the relationship between the diagnosed condition and 

specific employment incident identified by the employee.9

ANALYSIS

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

medical condition in connection with the accepted October 29, 2021 employment incident.

In support of his claim, appellant submitted an October 29, 2021 report from Dr. Horstman 

who documented a head and left lower extremity injury that occurred when he was rear ended 

while stopped in his LLV. Dr. Horstman noted a clinical impression of motor vehicle accident. 

The Board has previously explained that a purported diagnosis of “injury” is not a firm diagnosis.10 

Likewise, Dr. Horstman’s impression of “motor vehicle accident” may establish that a motor 

vehicle accident occurred on October 29, 2021, but does not provide a valid diagnosis. The mere 

acknowledgment of how an incident occurred, or that it caused an injury, does not constitute a 

valid medical diagnosis necessary to establish fact of injury.11

Appellant submitted reports from Mr. Hoerning, a nurse practitioner, dated November 4 

through 23, 2021. However, certain healthcare providers such as physical therapists, nurse

practitioners, nurses, and physician assistants are not considered physicians as defined under 

FECA.12 Consequently, their medical findings and/or opinions will not suffice for purposes of 

establishing entitlement to FECA benefits. As such, this evidence is of no probative value and 

insufficient to meet appellant’s burden of proof.

OWCP received discharge instructions dated October 29, 2021 bearing an illegible 

signature.13 Reports that are unsigned or that bear illegible signatures cannot be considered 

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 See J.L., Docket No. 18-1804 (issued April12, 2019).

11 See G.W., Docket No. 16-0517 (issued April27, 2016).

12 Section 8102(2) of FECA provides as follows: (2) 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. § 8102(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); 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); see alsoB.D., Docket No. 22-0503 (issued September 27, 2022 (nurse practitioners are not considered 

physicians as defined under FECA and their medical findings and/or opinions will not suffice for purposes of 

establishing entitlement to FECA benefits); L.S., Docket No. 19-1231 (issued March 30, 2021) (a nurse practitioner 

is not considered a physician as defined under FECA).

13 20 C.F.R. § 10.331(a) provides that use of medical report forms is not required; however, the report should bear 

the physician’s signature or signature stamp.
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probative medical evidence because they lack proper identification14 as the author cannot be 

identified as a physician.15

Appellant also submitted a CT scan and x-rays. The Board has held that diagnostic studies, 

standing alone, lack probative value on the issue of causal relationship as they do not provide an 

opinion as to whether the employment incident caused any of the diagnosed conditions.16 This 

evidence is, therefore, insufficient to establish appellant’s claim. 

The Board finds that there is no evidence of record that establishes a valid medical 

diagnosis from a qualified physician in connection with the accepted employment incident. 

Consequently, appellant 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 10.607.15.

CONCLUSION

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

medical condition in connection with the accepted October 29, 2021 employment incident.

14 W.L., Docket No. 19-1581 (issued August5, 2020); MertonJ. Sills, 39 ECAB 572, 575 (1988).

15 D.T., Docket No. 20-0685 (issued October 8, 2020);MertonJ. Sills,id.

16 C.B., Docket No. 20-0464 (issued July 21, 2020).
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ORDER

IT IS HEREBY ORDERED THAT the December 16, 2021 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: October 27, 2022

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board