United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

P.G., Appellant

and

U.S. POSTAL SERVICE, KANSAS CITY MAIN 

POST OFFICE, Kansas City, MO, Employer

__________________________________________

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Docket No. 22-0599

Issued: October 19, 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

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On March 14, 2022 appellant filed a timely appeal from a January 11, 2022 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 in connection with the accepted September 6, 2021 employment incident.

1

5 U.S.C. § 8101 et seq.

2 The Board notes that following the January 11, 2022 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 September 8, 2021 appellant, then a 51-year-old mail handler technician, filed a 

traumatic injury claim (Form CA-1) alleging that on September 6, 2021 she sustained a right 

shoulder strain when she reached into a box to remove heavy mail trays and used her left arm to 

pull the trays up the side of the box while in the performance of duty. She did not stop work, but 

began working in a modified-duty position.

In an authorization for examination and/or treatment (Form CA-16) dated September 6, 

2021, Brian E. Thompson, a family nurse practitioner, indicated that appellant reported having 

right shoulder pain after reaching and pulling mail trays. He diagnosed right shoulder strain and 

checked a box marked “Yes” to indicate that the diagnosed condition was caused or aggravated by 

the reported employment activity. In separate reports of even date, Mr. Thompson noted 

appellant’s complaints and indicated that she had limited use of her right arm. He diagnosed strain 

of unspecified muscle, fascia, and tendon at the right shoulder/upper arm.

In a September 27, 2021 report, Dr. Walter Porter, a Board-certified emergency medicine 

physician, indicated that appellant reported injuring her right shoulder and neck at work on

September 6, 2021 due to pulling mail trays. He noted that, upon physical examination of the right 

shoulder, appellant exhibited full range of motion and tenderness in the anterior of the shoulder. 

Dr. Porter diagnosed right shoulder injury and recommended physical therapy. 

In an October 4, 2021 report, Dr. Nancy Moran, a Board-certified family medicine 

physician, identified the date of injury as September 6, 2021 and noted that appellant presented 

with right shoulder pain. She reported physical examination findings, noting that appellant had 

full range of motion of her right shoulder, and diagnosed right shoulder injury. In a report of even 

date, Dr. Moran advised that appellant could return to modified work on a full-time basis. On 

October 8, 2021 she indicated that a magnetic resonance imaging (MRI) scan of the right shoulder 

showed possible tears of the infraspinatus/supraspinatus tendons. Dr. Moran continued to 

diagnose right shoulder injury. On October 12, 2021 she reported that appellant could return to 

full-duty work.

In a November 23, 2021 report, Dr. Prem Parmar, a Board-certified orthopedic surgeon, 

noted that appellant reported injuring her right shoulder by pulling heavy mail trays at work on 

September 6, 2021. Appellant also reported that for 27 years at the employing establishment she 

had “done a lot” of repetitive reaching, pulling, lifting, and pushing. Dr. Parmar advised that the 

physical examination revealed full range of motion of both shoulders with some discomfort above 

the horizon on the right. The impingement test was minimally positive in the right shoulder. 

Dr. Parmar diagnosed right shoulder impingement-type symptoms and a partial-thickness tear of 

the right rotator cuff. He indicated, “I believe the prevailing factor for these issues is her workrelated injury as well as her repetitive job activities at the postal service for the past over 2-1/2 

decades.” Dr. Parmar recommended continued physical therapy and medication.
3

In a December 8, 2021 development letter, OWCP informed appellant of the deficiencies 

of her claim.3 It advised her of the type of evidence needed and provided a questionnaire for her 

completion. OWCP afforded her 30 days to respond.

Appellant submitted a December 7, 2021 report in which Dr. Parmar indicated that her 

right shoulder condition was slowly improving. In reports dated November 23, December 7, 2021, 

and January 4, 2022, Rita C. Calderon4 discussed appellant’s right shoulder condition and her

medical treatment plans.

By decision dated January 11, 2022, OWCP accepted that the September 6, 2021 

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

evidence of record was insufficient to establish a diagnosed medical condition in connection with 

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

been met 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 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.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 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.7 The second component is whether the employment incident caused a personal 

injury.8 

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. 9 

3 OWCP indicated that appellant’s claim had been administratively approved for a limited amount of medical 

expenses but that the merits of the claim had not been formally considered.

4 Ms.Calderon’s credentials are not found in the case record. 

5

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

ECAB 312 (1988).

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

DeloresC. Ellyett, 41 ECAB 992 (1990).

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

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

9

S.S.,Docket No. 18-1488 (issued March 11, 2019). 
4

Neither the mere fact that a disease or condition manifests itself during a period of employment, 

nor the belief that the disease or condition was caused or aggravated by employment factors or 

incidents is sufficient to establish causal relationship.10

ANALYSIS

The Board finds that appellant has appellant has met her burden of proof to establish a 

diagnosed medical condition in connection with the accepted September 6, 2021 employment 

incident. 

Appellant submitted a November 23, 2021 reportfrom Dr. Parmarwho noted that appellant 

reported injuring her right shoulder by pulling heavy mail trays at work on September 6, 2021.

Dr. Parmar indicated that appellant had also reported that for 27 years at the employing 

establishment she had “done a lot” of repetitive reaching, pulling, lifting, and pushing. He

diagnosed right shoulder impingement-type symptoms and a partial-thickness tear of the right 

rotator cuff. Dr. Parmar indicated, “I believe the prevailing factor for these issues is her workrelated injury as well as her repetitive job activities at the postal service for the past over 2-1/2 

decades.” The Board finds that this evidence establishes a diagnosis of a partial-thickness tear of 

the right rotator cuff in connection with the accepted September 6, 2021 employment incident.

The Board further finds, however, that this case is not in posture for decision with regard 

to whether the diagnosed medical condition is causally related to the accepted September 6, 2021 

employment incident. As the medical evidence of record establishes a diagnosed medical 

condition, the case must be remanded for consideration of the medical evidence with regard to the 

issue of causal relationship.11 Following this and other such further development as deemed 

necessary, OWCP shall issue a de novo decision.

CONCLUSION

The Board finds that appellant has appellant has met her burden of proof to establish a 

diagnosed medical condition in connection with the accepted September 6, 2021 employment 

incident. The Board further finds, however that this case is not in posture for decision with regard 

to whether the diagnosed medical condition is causally related to the accepted September 6, 2021 

employment incident.

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

11 See V.S., Docket No. 22-0105 (issued July 18, 2022); F.D., 21-1045 (issued December 22, 2021).
5

ORDER

IT IS HEREBY ORDERED THAT the January 11, 2022 decision of the Office of 

Workers’ Compensation Programs is set aside and the case is remanded for further proceedings 

consistent with this decision of the Board.

12

Issued: October 19, 2022

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board

12 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).