United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

J.D., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Hartford, CT, Employer

__________________________________________

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Docket No. 21-1422

Issued: May 24, 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

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On September 24, 2021 appellant filed a timely appeal from a July 29, 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 established a medical condition causally related to the 

accepted February 11, 2021 employment incident.

FACTUAL HISTORY

On February 17, 2021 appellant, then a 59-year-old city carrier, filed a traumatic injury 

claim (Form CA-1) alleging that on February 11, 2021 he injured his right leg, thigh, buttocks 

area, and the right side of his lower back when lifting flats sequencing systems tray while in the 

performance of duty. On the reverse side of the claim form, his supervisor, T.M., acknowledged 

1

5 U.S.C. § 8101 et seq.
2

that appellant was injured while in the performance of duty. Appellant stopped work on 

February 11, 2021.

In support of his claim, appellant submitted a February 11, 2021 authorization for 

examination and/or treatment (Form CA-16) from a health and resource management specialist, 

B.K., authorizing office and/or hospital treatment as necessary for the effects of strain and pain of 

the lower back. 

In a duty status report (Form CA-17) also dated February 11, 2021, Caitlin Cole, a 

physician assistant, indicated that appellant was injured when he lifted a 30-pound mail tray and 

carried it 25 feet before placing it down. Ms. Cole found tenderness and tightening of the right 

lower back and radiating pain down to the right posterior thigh. She diagnosed a muscle spasm 

and advised that appellant should not return to work. In a medical form report of even date,

Ms. Cole noted that appellant sustained an injury to his right leg, thigh, buttocks, and lower back. 

Appellant subsequently submitted a February 16, 2021 medical report from Dr. Kenneth 

Kramer, a Board-certified orthopedic surgeon specializing in spinal conditions, relating that 

appellant developed sudden lower back pain after lifting a tray at work on February 11, 2021. 

Dr. Kramer noted that appellant reported constant pain in the right lumbar region with radiation to 

the buttock and thigh, as well as uncomfortable ambulation, and had been unable to work since the 

date of injury. His examination revealed significant right-sided lumbar antalgia, guarding, 

stooping, and limitations in lumbar motion producing right lumbosacral pain with right sciatic 

notch tenderness and positive right sciatic signs. Dr. Kramer indicated that lumbopelvic x-rays

taken on the date of examination were generally unremarkable. He diagnosed sciatica of the right 

side. Dr. Kramer advised that appellant remained unable to work. In a work excuse note of even 

date, he noted that appellant should remain off work until his follow-up appointment on 

February 22, 2021.2

In a February 22, 2021 report, Dr. Kramer noted appellant’s persistent, bothersome 

anterolateral thigh and leg paresthesias. His examination revealed right-sided antalgia. 

Dr. Kramer diagnosed a herniated lumbar disc and sciatica of the right side and advised that 

appellant remained totally temporarily disabled. In an attending physician’s report (Form CA-20) 

of even date, he related appellant’s history of injury and noted that February 16, 2021 x-rays were 

unremarkable, but a February 19, 2021 MRI scan showed a herniated disc. Dr. Kramer diagnosed 

sciatica and affirmatively indicated by checking a box marked “Yes” that appellant’s condition 

was caused or aggravated by the claimed employment incident. He indicated that appellant was 

temporarily totally disabled from February 16 through March 1, 2021, when he would be 

reevaluated. A Form CA-17 and work excuse note of even date advised the same.

In a development letter dated March 2, 2021, OWCP informed appellant of the deficiencies 

of his claim. It advised him as to the type of factual and medical evidence required and provided 

a questionnaire for his completion. OWCP afforded appellant 30 days to respond. 

2 On February 19, 2021 appellant underwent a magnetic resonance imaging (MRI) scan of the lumbar spine,which

revealed L4-5 right foraminal disc herniation, mild disc bulging, and mild bilateral facet arthropathy; L3-4 minimal 

disc bulging and small right subarticular-foraminal disc protrusion with an annular fissure; and L5-S1 minimal disc 

bulging, central-left paracentral disc protrusion with an annular fissure, and mild bilateral facet arthroscopy. 
3

OWCP subsequently received a February 11, 2021 medical form report from Ms. Cole 

relating appellant’s history of injury. Ms. Cole’s examination revealed tenderness to palpation in 

the middle and lower right back and glute. She diagnosed a muscle spasm and administered a 

ketorolac injection. 

In a March 1, 2021 medical report,Dr. Kramer noted that appellant continued to experience 

debilitating right sciatica and limitations on standing and sitting, but that physical therapy was 

helping somewhat. He continued to diagnose a herniated lumbar disc and sciatica of the right side, 

as well as a workplace accident. Dr. Kramer advised that appellant should remain on temporary 

total disability. In a work status report of even date, he affirmatively indicated that appellant’s 

lumbar condition was work related. 

Dr. Kramer, in a March 15, 2021 medical report, related appellant’s ongoing symptoms 

and continued to diagnose sciatica of the right side and a workplace accident. He advised that 

appellant should remain on temporary total disability. In a Form CA-17, Form CA-20, and work 

status report of even date, Dr. Kramer indicated that appellant’s condition was work related. 

In an undated report of work status (Form CA-3), B.K., an employing establishment 

official, indicated that appellant stopped work on February 12, 2021 and returned to work full time 

with restrictions on March 30, 2021. 

By decision dated April 5, 2021, OWCP denied appellant’s traumatic injury claim, finding 

that the evidence of record was insufficient to establish that his medical condition was causally 

related to the accepted February 11, 2021 employment incident. 

Appellant subsequently submitted a March 29, 2021 medical report from Dr. Kramer in 

which he diagnosed sciatica of the right side and a workplace accident. Dr. Kramer reported that 

appellant was improving and was cleared to return to work with a 20-pound lifting limit. In a 

Form CA-17 of even date, Dr. Kramer diagnosed lumbar strain and advised that appellant could 

return to work on March 29, 2021 with restrictions on lifting, carrying, standing, walking, twisting, 

pulling, and pushing. His work status report of even date affirmatively indicated that appellant’s 

condition was work related. 

In an April 19, 2021 medical report, Dr. Kramer noted that appellant continued to improve 

and could return to regular work. He diagnosed sciatica of the right side, a lumbar sprain, and a 

workplace accident. Dr. Kramer directly addressed OWCP’s April 5, 2021 decision on the basis 

of causal relationship, stating that the denial was “clear impedimentary nonsense,” explaining that 

the mechanism of injury was well described in his medical report from February 16, 2021 and 

noting that appellant’s injury was documented at work. In a Form CA-17 and work status report 

of even date, he indicated that appellant’s condition was work related and that he could return to 

work without limitations on April 20, 2021. 

On May 5, 2021 appellant requested reconsideration. 

OWCP also received May 10 and June 28, 2021 reports from Dr. Kramer, noting that 

appellant continued to improve, but had residual lower back pain. In the May 10, 2021 report, Dr. 

Kramer diagnosed a herniated lumbar disc, lumbar sprain, and a workplace accident. In the 

June 28, 2021 report, he diagnosed a lumbar sprain and a workplace accident and noted that 

appellant was tolerating his regular work. 
4

By decision dated July 29, 2021, OWCP denied modification of its April 5, 2021 decision. 

LEGAL PRECEDENT

An employee seeking benefits under FECA3 has the burden of proof to establish the 

essential elements of his or her claim, including the fact 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 period 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 an employee has sustained a traumatic injury in the performance of 

duty, OWCP begins with an analysis of whether fact of injury has been established. Fact of injury 

consists of two components that must be considered in conjunction with one another. The first 

component is whether the employee actually experienced the employment incident that allegedly 

occurred.

7

 The second component is whether the employment incident caused a personal injury.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 specific employment factors 

identified by the employee.10

ANALYSIS

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

condition causally related to the accepted February 11, 2021 employment incident.

3

Supra note 1.

4

S.S., Docket No. 19-1815 (issued June26, 2020); S.B., Docket No. 17-1779 (issued February 7, 2018); JoeD. 

Cameron, 41 ECAB 153 (1989).

5 M.H., Docket No. 19-0930 (issued June 17, 2020); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40 ECAB 

312 (1988).

6

S.A., Docket No. 19-1221 (issued June 9, 2020); L.M., Docket No. 13-1402 (issued February 7, 2014); DeloresC. 

Ellyett, 41 ECAB 992 (1990).

7 R.K., Docket No. 19-0904 (issued April10, 2020); Elaine Pendleton, 40 ECAB 1143 (1989).

8 Y.D., Docket No. 19-1200 (issued April6, 2020); 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 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).
5

In a February 16, 2021 medical report, Dr. Kramerrelated that appellant developed sudden 

lower back pain after lifting a tray at work on February 11, 2021 and diagnosed sciatica of the right 

side and an acute lumbar injury. In medical reports dated March 1, March 15, March 29, April 19, 

May 10, and June 28, 2021, he indicated that appellant sustained a workplace accident. In forms 

CA-17 dated March 15 and April 19, 2021, Dr. Kramer diagnosed work-related sciatica on the 

right side. Similarly, in forms CA-20 dated February 22 and March 15, 2021 and in work status 

reports dated March 1, March 15, March 29, and April 19, 2021 he responded affirmatively that 

the diagnosed condition was caused or aggravated by the claimed employment incident. Although 

Dr. Kramer suggested a work-related cause for appellant’s lower back condition in each report, he 

did not provide a rationalized medical opinion relating the specific diagnosed condition to the 

February 11, 2021 employment incident. The Board has held that a report is of limited probative 

value regarding causal relationship if it does not contain medical rationale explaining how an

employment activity could have caused or aggravated a medical condition. 11 Therefore, these 

reports are insufficient to establish appellant’s traumatic injury claim.

In a February 22, 2021 report, Dr. Kramer diagnosed a herniated lumbar disc and sciatica

of the right side. In work excuse notes dated February 16 and 22, 2021, he advised that appellant 

should remain off work pending reevaluation. In a March 29, 2021 Form CA-17, Dr. Kramer 

related appellant’s history of injury, diagnosed lumbar strain, and advised that appellant could 

return to work on March 29, 2021 with restrictions. However, he did not offer an opinion on causal 

relationship in any of this evidence. The Board has held that medical evidence 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 For this reason, this medical evidence is insufficient to meet appellant’s 

burden of proof.

The remaining medical evidence consists of medical records by Ms. Cole, a physician 

assistant. The Board has held 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 

physicians as defined under FECA and are, therefore,not competent to provide medical opinions.13 

Consequently, their medical findings and/or opinions will not suffice for the purpose of 

establishing entitlement to FECA benefits.

As appellant has not submitted rationalized medical evidence establishing that his medical

condition is causally related to the accepted February 11, 2021 employment incident, the Board 

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

11 Y.D., Docket No. 16-1896 (issued February 10, 2017).

12 S.J., Docket No. 19-0696 (issued August23, 2019); M.C., Docket No. 18-0951 (issued January 7, 2019); L.B., 

Docket No. 18-0533 (issued August27, 2018); D.K., Docket No. 17-1549 (issued July 6, 2018).

13 Section 8101(2) of FECA provides that physician “includes surgeons, podiatrists, dentists, clinical psychologists, 

optometrists, chiropractors, and osteopathic practitioners within the scope of their pra ctice as defined by State law.” 

5 U.S.C. § 8101(2); 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); R.L., Docket No. 19-0440 (issued July 8, 2019) (a physician 

assistant is not considered a physician as defined under FECA); 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). 
6

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 10.607.14

CONCLUSION

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

condition causally related to the accepted February 11, 2021 employment incident.

ORDER

IT IS HEREBY ORDERED THAT the July 29, 2021 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: May 24, 2022

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

14 The Board notes that the employing establishment issued a Form CA-16, dated February 11, 2021. A completed 

Form CA-16 authorization may constitute a contract for payment of medical expenses to a medical facility or 

physician, when properly executed. The form creates a contractual obligation, which does not involve the employee 

directly, to pay for the cost of the examination or treatment regardless of the action taken on the claim. See 20 C.F.R. 

§ 10.300(c); V.S., Docket No. 20-1034 (issued November 25, 2020); J.G., Docket No. 17-1062 (issued February 13, 

2018); Tracy P. Spillane, 54 ECAB 608 (2003).