United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

D.L., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Tampa, FL, Employer

__________________________________________

)

)

)

)

)

)

)

)

Docket No. 23-0356

Issued: July 27, 2023

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

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On January 5, 2023 appellant filed a timely appeal from a November 16, 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.

ISSUE

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

condition in connection with the accepted September 27, 2022 employment incident.

FACTUAL HISTORY

On October 5, 2022 appellant, then a 40-year-old rural carrier, filed a traumatic injury 

claim (Form CA-1) alleging that on September 27, 2022 she sustained injury to her right foot when 

1

5 U.S.C. § 8101 et seq.
2

she stepped out of her postal vehicle and “hurled” her foot forward and heard a popping sound

while in the performance of duty. She did not stop work.

Appellant submitted the authorization page of an authorization for examination and/or 

treatment (Form CA-16), which was signed by her supervisor on September 27, 2022. In a 

September 27, 2022 narrative report, Maria Ortiz, a nurse practitioner, indicated that appellant 

reported that on September 27, 2022 she jumped down from her postal vehicle and felt a crack in 

her right foot. She detailed her physical examination findings, including tenderness in the right 

foot metatarsals, and diagnosed “right foot injury.” A portion of the report, signed by Laura

Cordoba, a nurse practitioner, contains a description of September 27, 2022 x-rays of appellant’s 

right foot. In a September 27, 2022 form report, Ms. Ortiz noted that appellant had sought 

treatment for a work-related injury and diagnosed right foot sprain. She checked a box to indicate 

that no functional limitations were identified, and no restrictions were prescribed.

In an October 3, 2022 narrative report, Alexandra Rigaud, a nurse practitioner, indicated 

that appellant reported that her right foot condition was “50 percent better” and that she was 

working in her regular job without restrictions. Ms. Rigaud diagnosed right foot sprain. In an 

October 3, 2022 form report, she diagnosed right foot sprain and checked a box to indicate that no 

functional limitations were identified and no restrictions were prescribed. 

In an October 12, 2022 development letter, OWCP notified appellant of the deficiencies of 

her claim. It advised her of the type of factual and medical evidence needed, including a narrative 

report from an attending physician which contained a diagnosis and opinion explaining how the 

reported work incident caused or aggravated a medical condition. OWCP afforded appellant 30 

days to respond. 

Appellant submitted an October 10, 2022 narrative report, in which Ms. Cordoba 

diagnosed right foot sprain and “work[-]related injury.” In an October 10, 2022 form report,

Ms. Cordoba diagnosed right foot sprain and checked a box to indicate that no functional 

limitations were identified and no restrictions were prescribed. 

By decision dated November 16, 2022, OWCP accepted that appellant had established the 

occurrence of the September 27, 2022 employment incident, as alleged. However, it denied her 

claim, finding that she had not submitted a medical report from a qualified physician which 

diagnosed a medical condition in connection with the accepted September 27, 2022 employment 

incident. 

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 and that the claim was filed within the applicable time 

limitation period of FECA 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 
3

the employment injury.2 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.3

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 at the time, place, and in the manner alleged.4 The second component is whether the 

employment incident caused a personal injury.5

Causal relationship is a medical issue, and the medical evidence required to establish causal 

relationship is rationalized medical opinion evidence.6 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. 7

ANALYSIS

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

medical condition in connection with the accepted September 27, 2022 employment incident. 

Appellant submitted a September 27, 2022 narrative report from Ms. Ortiz, a nurse 

practitioner, who indicated that appellant reported that on September 27, 2022 appellant jumped 

down from her postal vehicle and felt a crack in her right foot. Ms. Ortiz detailed her physical 

examination findings, including tenderness in the right foot metatarsals and diagnosed “right foot 

injury.” A portion of the report, signed by Ms. Cordoba, a nurse practitioner, contains a description 

of September 27, 2022 x-rays of appellant’s right foot. In a September 27, 2022 form report,

Ms. Ortiz noted that appellant had sought treatment for a work-related injury and diagnosed right 

foot sprain. In an October 3, 2022 narrative report and form report of the same date, Ms. Rigaud, 

a nurse practitioner, diagnosed right foot sprain. In an October 10, 2022 narrative report,

Ms. Cordoba diagnosed right foot sprain and “work[-]related injury.” In an October 10, 2022 form 

report, she diagnosed right foot sprain.

2

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

ECAB 312 (1988).

3 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).

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

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

6

S.S.,Docket No. 19-0688 (issued January24, 2020); A.M.,Docket No. 18-1748 (issued April24, 2019); RobertG. 

Morris, 48 ECAB 238 (1996).

7 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).
4

The Board notes, however, that certain healthcare providers such as physician assistants, 

nurse practitioners, physical therapists, and social workers are not considered physicians as defined 

under FECA.8 Consequently, their medical findings and/or opinions will not suffice for purposes 

of establishing entitlement to FECA benefits.9

As the medical evidence of record is insufficient to establish a medical condition 

diagnosed in connection with the accepted September 27, 2022 employment incident, the Board 

finds that appellant has not met her 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.

CONCLUSION

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

medical condition in connection with the accepted September 27, 2022 employment incident.

8 Section 8102(2) of FECA provides that 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. § 8101(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 also J.D.,Docket No. 21-0164 (issued June15, 2021) (nurse practitioners are not physicians as defined 

under FECA); A.M.,Docket No. 20-1575 (issued May 24, 2021) (physical therapists are not physicians as defined by 

FECA).

9

Id.
5

ORDER

IT IS HEREBY ORDERED THAT the November 16, 2022 decision of the Office of 

Workers’ Compensation Programs is affirmed.10

Issued: July 27, 2023

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board

10 The case record contains a Form CA-16 signed by appellant’s supervisor on September 27, 2022. A properly 

completed Form CA-16 form 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).