United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

J.R., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Hartford, CT, Employer

__________________________________________

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Docket No. 21-1257

Issued: April 27, 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 August 16, 2021 appellant filed a timely appeal from a June 22, 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.

2

ISSUE

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

causally related to the accepted May 10, 2020 employment incident.

1

5 U.S.C. § 8101 et seq.

2 The Board notes that, following the February17, 2021 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 May 19, 2020 appellant, then a 70-year-old postal distribution associate, filed a 

traumatic injury claim (Form CA-1) alleging that on May 10, 2020 she sustained a right elbow 

injury3 when lifting letter trays from the high-speed tray sorter while in the performance of duty. 

She did not stop work. 

In a May 13, 2020 note, Nisha Malik, a physician assistant, indicated that appellant related 

complaints of right arm pain, which she attributed to lifting a heavy box from a conveyor belt on 

May 9, 2020. She noted that she described sudden pain around the elbow, followed by swelling. 

Ms. Malik performed a physical examination and documented mild swelling and tenderness to 

palpation over the lateral epicondyle of the right elbow. She diagnosed right elbow pain and 

recommended that appellant undergo an x-ray of the right elbow. 

An x-ray of the right elbow, also dated May 13, 2020, was read as normal. 

In a follow-up note dated May 26, 2020, Ms. Malik noted a history of prior x-rays of the 

left elbow taken on April 24, 2016, which revealed medial and lateral epicondylitis. She again 

diagnosed right arm pain. 

In a note dated June 10, 2020, Lauren Phillips, a physician assistant, documented 

appellant’s ongoing complaints of right elbow pain. She diagnosed right elbow pain and 

recommended physical therapy. 

Natasha Rodriguez, a physician assistant, in a note dated June 19, 2020, diagnosed right 

arm pain. A separate order form of even date indicated that appellant was referred to undergo a 

magnetic resonance imaging (MRI) scan of the right elbow for a diagnosis of right elbow pain by

Dr. Thomas Gartman, an internist. 

In a letter dated July 21, 2020, Ms. Rodriguez recommended light-duty work with no 

lifting, pushing, or pulling over 20 pounds. 

In an occupational therapy evaluation dated August 20, 2020, Lisa Blain, a registered 

occupational therapist, indicated that appellant related a history of right arm pain, which she 

attributed to picking up a heavy box in April 2020. She performed a physical examination and 

diagnosed pain and lateral epicondylitis of the right elbow. 

In a follow-up note and letter dated September 1, 2020, Ms. Phillips recommended ongoing 

restrictions of lifting no more than 20 pounds.

Elvis Smith, a physician assistant in orthopedics, indicated in a note dated September 17, 

2020, that appellant stated that her correct date of injury was May 10, 2020. He noted that she 

described attempting to lift a heavy box at work and f eeling something give in the right elbow. 

3 OWCP previously processed a traumatic injury claim for an October 8, 2015 right elbow injury as a short form 

closure under OWCP File No. xxxxxx740. That claim is not presently before the Board.
3

Mr. Smith performed a physical examination and diagnosed lateral epicondylitis of the right 

elbow.

Therapy notes dated October 19 and 20, 2020 documented ongoing occupational therapy 

with Ms. Blain. 

OWCP, in a January 15, 2021 development letter, advised appellant of the deficiencies of 

her claim, requested additional factual and medical evidence, and provided a questionnaire for her 

completion. It afforded her 30 days to respond. No additional evidence was received.

By decision dated June 22, 2021, OWCP accepted that the May 10, 2020 employment 

incident occurred as alleged. However, it denied the claim, finding that the medical evidence of 

record was insufficient to establish a medical condition causally related to the accepted 

employment incident. Consequently, OWCP found that appellant had not met the requirements to 

establish an injury as defined by FECA.

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 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 that the 

employee must submit sufficient evidence to establish that 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 

4

Supra note 1.

5 F.H., Docket No.18-0869 (issued January 29, 2020); J.P., Docket No. 19-0129 (issued December 13, 2019); 

Joe D. Cameron, 41 ECAB 153 (1989). 

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).
4

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 her burden of proof to establish a medical 

condition causally related to the accepted May 10, 2020 employment incident. 

In support of her claim, appellant submitted a June 19, 2020 MRI scan referral by

Dr. Gartman for a diagnosis of pain in the right elbow. The Board has held that pain is a description 

of a symptom, not a clear diagnosis of a medical condition. 11 As such, Dr. Gartman’s note is 

insufficient to meet appellant’s burden of proof.

In further support of her claim, appellant also submittedvariousmedical notes by physician 

assistants and a registered occupational therapist. This Board has long held that certain healthcare 

providers such as physician assistants and occupational therapists are not considered physicians as 

defined under FECA.12 Their medical findings, reports and/or opinions, unless cosigned by a 

qualified physician, will not suffice for purposes of establishing entitlement to FECA benefits. 13 

Consequently, these reports are insufficient to meet appellant’s burden of proof.

The remaining medical evidence includes radiographic studies of appellant’s right elbow. 

The Board has held, however, that diagnostic studies, standing alone, lack probative value and are 

insufficient to establish the claim.14

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).

11 D.R., Docket No. 18-1408 (issued March 1, 2019); D.A., Docket No. 18-0783 (issued November 8, 2018).

12 Section 8101(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); C.G., Docket No. 20-0957 (issued January 27, 2021); 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 K.A., Docket No. 18-0999 (issued 

October 4, 2019).

13 K.A., id.; K.W., 59 ECAB 271, 279 (2007); David P. Sawchuk,id.

14 J.K., Docket No. 20-0591 (issued August 12, 2020); J.P., supra note 5; A.B., Docket No. 17-0301 (issued 

May 19, 2017).
5

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

related to the accepted May 10, 2020 employment incident, the Board finds that she 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 medical 

condition causally related to the accepted May 10, 2020 employment incident.

ORDER

IT IS HEREBY ORDERED THAT the June 22, 2021 decision of the Office of Workers’

Compensation Programs is affirmed. 

Issued: April 27, 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