United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

T.S., Appellant

and

U.S. POSTAL SERVICE, TAYLORSVILLE 

POST OFFICE, Taylorsville, MS, Employer

__________________________________________

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Docket No. 20-0659

Issued: September 21, 2020

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

JANICE B. ASKIN, Judge

PATRICIA H. FITZGERALD, Alternate Judge

JURISDICTION

On February 3, 2020 appellant filed a timely appeal from a January 9, 2020 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 her burden of proof to establish a diagnosed medical 

condition causally related to the accepted November 19, 2019 employment incident.

 

1 5 U.S.C. § 8101 et seq.

2 The Board notes that, following the January 9, 2020 decision, OWCP received additional evidence. 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 20, 2019 appellant, then a 43-year-old rural carrier, filed a traumatic injury 

claim (Form CA-1) alleging that on November 19, 2019 she sustained a left shoulder condition 

when pulling down mail from a shelf of a case while in the performance of duty. She stopped 

work on the date of the alleged injury.

The employing establishment properly executed an authorization for examination and/or 

treatment (Form CA-16) on November 20, 2019. The Form CA-16 noted appellant’s history of a 

left shoulder injury on November 19, 2019.

In a note dated November 20, 2019, Sharon Scruggs, a certified family nurse practitioner, 

related that appellant was seen on that date and that she would be released to return to work pending 

a follow-up appointment on November 25, 2019.

In a development letter dated December 2, 2019, OWCP advised appellant that additional 

medical evidence was necessary to establish her claim. It indicated that the evidence it received 

had been signed by a nurse practitioner; however, it explained that medical evidence must be 

submitted by a qualified physician, and that nurse practitioners and physical therapists are not

considered qualified physicians under FECA unless their medical reports are counter-signed by a 

physician. Appellant was also advised that pain was a symptom, not a valid diagnosis. OWCP

informed appellant of the medical evidence necessary to establish her claim and afforded 30 days 

for appellant to respond.

OWCP subsequently received additional evidence. In a November 20, 2019 attending 

physician’s report (Part B of the Form CA-16), Ms. Scruggs listed a diagnosis of left shoulder 

pain. In a separate report of the same date, she reviewed appellant’s history of injury, conducted 

a physical examination, and diagnosed left shoulder pain.

In a follow-up report dated November 25, 2019, Ms. Scruggs noted that appellant’s left 

shoulder pain improved on rest. She noted a diagnosis of left shoulder pain. In a note dated 

November 25, 2019, Ms. Scruggs stated that she had seen appellant on that date and that she was 

unable to return to work until further notice.

In a duty status report (Form CA-17) dated December 5, 2019, Billy R. Windham, a 

certified nurse practitioner, noted clinical findings of left supraspinatus tendinitis and 

recommended work restrictions.

OWCP also received a December 5, 2019 work status form report by Mr. Windham, which

noted appellant’s work restrictions and a physical/occupational therapy order of the same date, 

also signed by Mr. Windham.

By letter dated December 11, 2019, the employing establishment controverted appellant’s 

claim. It noted that she had not submitted medical evidence containing a signature from a qualified 

physician and that the work restrictions of December 5, 2019 were inconsistent with appellant’s

claimed injury.
3

On December 17, 2019 Kayla Spradley, a physical therapist, reported that she had 

conducted therapeutic exercise to treat appellant’s left supraspinatus sprain.

In a work status report form dated January 6, 2020, Mr. Windham related that appellant 

had no work restrictions and could resume regular-duty work immediately.

By decision dated January 9, 2020, OWCP accepted that the November 19, 2019 

employment incident had occurred, as alleged. However, it denied the claim, finding that the 

medical evidence of record was insufficient to establish a diagnosed medical condition causally 

related to the accepted employment incident. Thus, appellant had not met the requirements to 

establish an injury as defined by FECA.

LEGAL PRECEDENT

An employee seeking benefits under FECA 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,

3

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 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 if 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.6 The second component is whether the employment incident caused a personal injury.7

Rationalized medical opinion evidence is required to establish causal relationship. The 

opinion of the physician must be based on a complete factual and medical background, 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.8

 

3 S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59 ECAB 178 (2007); Joe D. Cameron, 41 ECAB 

153 (1989).

4

J.M., Docket No. 17-0284 (issued February 7, 2018); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40 

ECAB 312 (1988).

5 K.M., Docket No. 15-1660 (issued September 16, 2016); L.M., Docket No. 13-1402 (issued February 7, 2014); 

Delores C. Ellyett, 41 ECAB 992 (1990).

6 B.P., Docket No. 16-1549 (issued January 18, 2017); Elaine Pendleton, 40 ECAB 1143 (1989).

7 M.H., Docket No. 18-1737 (issued March 13, 2019); John J. Carlone, 41 ECAB 354 (1989).

8 M.O., Docket No. 19-1398 (issued August 13, 2020); J.L., Docket No. 18-1804 (issued April 12, 2019).
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 November 19, 2019 employment incident.

In support of her claim, appellant submitted reports, work excuse notes, duty status reports, 

and records of physical therapy dated from November 20, 2019 through January 6, 2020 signed 

by a physical therapist and/or nurse practitioners. The Board has held that medical reports signed 

solely by a nurse practitioner or a physical therapist are of no probative value, as such healthcare 

providers are not considered physicians as defined under FECA, and therefore are not competent 

to provide a medical opinion.9 Consequently, these reports will not suffice for purposes of 

establishing entitlement to FECA benefits.

As appellant has not submitted rationalized medical evidence from a qualified physician 

establishing a diagnosed medical condition causally related to the accepted November 19, 2019 

employment incident, the Board finds that she has not met her burden of proof.10

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 November 19, 2019 employment incident.

 

9 5 U.S.C. § 8101(2) (this subsection 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); 

see David P. Sawchuk 57 ECAB 316, 320 n.11 (2006) (lay individuals such as physician assistants, nurse practitioners,

and physical therapists are not competent to render a medical opinion under FECA). See also D.H., Docket No. 18-

0072 (issued January 21, 2020) (physical therapists are not considered physicians under FECA); S.J., Docket No. 17-

0783, n.2 (issued April 9, 2018) (nurse practitioners are not considered physicians under FECA).

10 The Board notes that the case record contains an authorization for examination and/or treatment (Form CA-16) 

dated November 20, 2019. A properly 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. The period for which treatment is authorized by a Form CA-16 is limited to 60 days 

from the date of issuance, unless terminated earlier by OWCP. 20 C.F.R. § 10.300(c); P.R., Docket No. 18-0737 

(issued November 2, 2018); N.M., Docket No. 17-1655 (issued January 24, 2018); Tracy P. Spillane, 54 ECAB 

608 (2003).
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ORDER

IT IS HEREBY ORDERED THAT the January 9, 2020 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: September 21, 2020

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board