United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

C.H., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE,

Detroit, MI, Employer

__________________________________________

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Docket No. 22-1186

Issued: December 22, 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

PATRICIA H. FITZGERALD, Deputy Chief Judge

JANICE B. ASKIN, Judge

JURISDICTION

On August 10, 2022 appellant filed a timely appeal from a June 24, 2022 merit decision of

the Office of Workers’ Compensation Programs (OWCP).1 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 The Board notes that, following the June 24, 2022merit 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 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

5 U.S.C. § 8101 et seq.

3 Appellant submitted a timely request for oral argument before the Board. 20 C.F.R. § 501.5(b). Pursuant to the 

Board’s Rules of Procedure, oral argument may be held in the discretion of the Board. 20 C.F.R. § 501.5(a). The 

Board, in exercising its discretion, denies appellant’s request for oral argument because the arguments on appeal can 

adequately be addressed in a decision based on a review of the case record. Oralargumentin this appeal would further 

delay issuance of a Board decision and not serve a useful purpose. As such, oral argument is denied and this decision 

is based on the case record as submitted to the Board.
2

ISSUE

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

condition causally related to the accepted March 21, 2022 employment incident.

FACTUAL HISTORY

On April 4, 2022 appellant, then a 55-year-old rural delivery specialist, filed a traumatic 

injury claim (Form CA-1) alleging that on March 21, 2022 he developed a right shoulder condition 

when delivering a package into a mailbox while in the performance of duty. He related that he felt

a sharp pain in his right shoulder that extended down to his wrist and the pain worsened until he was 

unable to raise his right shoulder on April 4, 2022. Appellant did not stop work.

Appellant submitted April 5 and 15, 2022 duty status reports (Form CA-17) from an 

unidentifiable certified nurse practitioner, noting a diagnosis of right shoulder tendinitis.

In a May 11, 2022 development letter, OWCP informed appellant of the deficiencies of his

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

him 30 days to submit the necessary evidence. 

In response to the development letter, appellant submitted April 28, 2022 progress notes 

from Dr. Timothy Lukas, a Board-certified orthopedic surgeon, diagnosing a right rotator cuff 

tear/impingement and releasing him to work with restrictions. Dr. Lukas noted that appellant 

reported that, in a previous incident occurringapproximately five years prior, he was delivering mail 

when he felt a pop in his shoulder and he subsequently experienced right shoulder pain over the past 

five years, with an increase in the past three weeks. He further indicated that appellant reported a 

history of physical therapy beginning approximately five years ago.

In a May 23, 2022 Form CA-17, an unidentifiable medical provider noted a diagnosis of 

right rotator cuff tear/impingement. In a work excuse letter of even date, Lori Nugent, a certified 

physician assistant, held appellant off work for a right rotator cuff tear/impingement.

By decision dated June 24, 2022, OWCP accepted that the March 21, 2022 employment 

incident occurred as alleged. However, it denied appellant’s traumatic injury claim, finding that the 

evidence of record was insufficient to establish causal relationship between his diagnosed right 

shoulder condition and the accepted March 21, 2022 employment incident.

LEGAL PRECEDENT

An employee seeking benefits under FECA4 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,5that an injury was sustained in the performance of duty as alleged, and that any disability 

4

Supra note 2.

5 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). 
3

or medical condition for which compensation is claimed is causally related to the employment 

injury.6 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. 7

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. There are two 

components involved in establishing fact of injury. The first component is whether 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.8

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

condition and an employment incident is rationalized medical opinion evidence.9 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 the specific employment incident 

identified by the claimant.10

In any case where a preexisting condition involving the same part of the body is present and 

the issue of causal relationship therefore involves aggravation, acceleration or precipitation, the 

physician must provide a rationalized medical opinion that differentiates between the effects of the 

work-related injury or disease and the preexisting condition.11

ANALYSIS

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

condition causally related to the accepted March 21, 2022 employment incident.

Appellant submitted April 28, 2022 progress notes in which Dr. Lukas diagnosed a right 

rotator cuff tear/impingement and noted that appellant reported that, in an incident occurring 

approximately five years prior, he was delivering mail when he felt a pop in his shoulder and he 

subsequently experienced right shoulder pain during the past five years. However, he did not

provide an opinion on causal relationship in these notes. The Board has held that a medical report 

6 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).

7 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).

8 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).

9

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).

10 A.S., Docket No. 19-1955 (issued April9, 2020);LeslieC. Moore, 52 ECAB 132 (2000).

11 Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.805.3e (January 2013);

K.G., Docket No. 18-1598 (issued January 7, 2020); M.S.,Docket No. 19-0913 (issued November 25, 2019).
4

that does not offer an opinion regarding the cause of an employee’s condition is of no probative 

value on the issue of causal relationship.12 Moreover, the need for a rationalized medical opinion is 

particularly important here, as appellant had a preexisting condition of right shoulder pain and a 

history of physical therapy for the condition.

13

 As such, Dr. Lukas’ April 28, 2022 progress notes 

are insufficient to establish appellant’s claim.

14

Appellant also submitted April 5 and 15, 2022 Form CA-17s signed by a certified nurse 

practitioner and a May 23, 2022 work excuse letter from Ms. Nugent, a certified physician assistant. 

However, certain healthcare providers such as nurse practitioners and physician assistants are not 

considered “physician[s]” as defined under FECA.15 Consequently, their medical findings or 

opinions will not suffice for purposes of establishing entitlement to FECA benefits. 16 

OWCP also received a May 23, 2022 Form CA-17 from an unidentifiable medical provider 

noting a diagnosis of right rotator cuff tear/impingement. The Board has held that reports that are 

unsigned or bear an illegible signature lack proper identification and cannot be considered probative 

medical evidence as the author cannot be identified as a physician.17 Therefore, this form is also 

insufficient to establish appellant’s claim.

As appellant has not submitted rationalized medical opinion evidence establishing a 

diagnosed condition causally related to the accepted March 21, 2022 employment incident, the 

Board finds that he has not met his burden of proof to establish his claim.

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.

12 See D.Y., Docket No. 20-0112 (issued June 25, 2020); L.B., Docket No. 18-0533 (issued August 27, 2018); D.K., 

Docket No. 17-1549 (issued July 6, 2018).

13 Supra note 11.

14 Supra note 12.

15 5 U.S.C. § 8101(2); 20 C.F.R. § 10.5(t).

16 Section 8101(2) of FECA provides that medical opinions can only be given by a qualified physician. This section 

defines a physician as 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) (January2013); H.K., 

Docket No. 19-0429 (issued September 18, 2019); K.W., 59 ECAB 271, 279 (2007); 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 J.D., Docket No. 21-0164 (issued June15, 2021) (nurse practitioners are not 

physicians as defined under FECA).

17 L.B., Docket No. 21-0353 (issued May 23, 2022); T.D., Docket No. 20-0835 (issued February 2, 2021); Merton J. 

Sills, 39 ECAB 572, 575 (1988).
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CONCLUSION

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

condition causally related to the accepted March 21, 2022 employment incident.

ORDER

IT IS HEREBY ORDERED THAT the June 24, 2022 decision of the Office of Workers’

Compensation Programs is affirmed. 

Issued: December 22, 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