United States Department of Labor

Employees’ Compensation Appeals Board

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B.R., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Jacksonville, FL, Employer

__________________________________________

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Docket No. 23-0546

Issued: August 29, 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

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On March 8, 2023 appellant filed a timely appeal from a February 7, 2023 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 August 16, 2022 employment incident.

FACTUAL HISTORY

On August 18, 2022 appellant, then a 48-year-old letter carrier, filed a traumatic injury 

claim (Form CA-1) alleging that on August 16, 2022 she injured her left foot and ankle while in 

the performance of duty. She indicated that her foot “went sideways” as she stepped off a bottom 

1

5 U.S.C. § 8101 et seq.
2

step onto the ground. On the reverse side of the claim form, appellant’s supervisor acknowledged 

that appellant was injured in the performance of duty. The form indicated that appellant stopped 

work on August 16, 2022. 

An x-ray report of the left ankle dated August 16, 2022 signed by Dr. David McKay, a 

Board-certified diagnostic radiologist, indicated lateral soft tissue swelling, but no fracture or 

dislocation. A left foot x-ray report of even date signed by Dr. John Boon, a Board-certified 

diagnostic radiologist, had no acute findings. 

On August 16, 2022 appellant was treated by Dr. Lee G. Barker, an osteopathic emergency 

medicine specialist. A work status note indicated that she was allowed to return to work without

restrictions. 

An x-ray report of the left foot dated August 29, 2022 and signed by Dr. David Bajayo, a 

Board-certified diagnostic radiologist, indicated soft tissue swelling dorsal aspect of the foot. 

A computerized (CT) scan report of the left foot dated September 6, 2022 by Dr. Romil Y. 

Patel, a diagnostic radiology specialist, indicated no fracture and nonspecific soft tissue edema. 

Appellant submitted a work status note dated September 19, 2022 with an illegible 

signature indicating that she was not yet at maximum medical improvement (MMI), but could 

return to work. Subsequent work status notes dated September 26 and October 4, 2022 with 

illegible signatures reiterated that she was not yet at MMI. 

In a letter dated October 4, 2022, the employing establishment indicated that appellant was 

provided a job offer for modified duty in accordance with her work restrictions. 

On October 5, 2022 OWCP received a work status report (Form CA-3) indicating that 

appellant stopped work on August 16, 2022 and returned on October 5, 2022 on modified duty. 

The modified job offer was accepted on October 5, 2022. 

A work status note dated October 24, 2022 with an illegible signature indicated that 

appellant could return to work at full duty, but was not at MMI. 

On October 25, 2022 OWCP received a Form CA-3 indicating that appellant stopped work 

on August 16, 2022 and returned on October 24, 2022 at full duty. 

OWCP received physical therapy progress notes dated from October 10 through 

November 9, 2022. The notes indicated appellant’s diagnosis of sprain of unspecified ligament of 

the left ankle.

In a development letter dated December 28, 2022, OWCP advised appellant of the 

deficiencies in her claim. It informed her that additional factual and medical evidence was 

necessary to establish her claim and provided a questionnaire for her completion. OWCP afforded 

appellant 30 days to respond. 

OWCP received a magnetic resonance imaging (MRI) scan report of the left foot dated 

September 15, 2022 by Dr. David Factor, a Board-certified diagnostic radiologist. Dr. Factor
3

indicated no fracture, but diffuse interstitial edema and possible foreign body near the ball of the 

foot. 

An x-ray report of the left tibia/fibula dated September 26, 2022 by Dr. Joseph S. Gurinsky,

a Board-certified diagnostic radiologist, indicated mild degenerative narrowing of the left knee 

medial compartment, but no evidence for bony lesion involving the distal left leg. 

By decision dated February 7, 2023, OWCP found that the August 16, 2022 incident had 

occurred as alleged, but denied appellant’s traumatic injury claim, finding that the evidence of 

record was insufficient to establish a diagnosed medical condition in connection with the accepted 

employment incident. It concluded, therefore, that the requirements had not been met to establish 

an injury as defined by FECA. 

LEGAL PRECEDENT

An employee seeking benefits under FECA2 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, 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.3 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.4

To determine whether an employee sustained a traumatic injury in the performance of duty, 

it must first be determined whether fact of injury has been established. There are two components 

involved in establishing fact of injury. The first component is whether the employee actually 

experienced the employment incident that allegedly occurred at the time, 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.5

Causal relationship is a medical question that requires rationalized medical opinion 

evidence to resolve the issue.6 A physician’s opinion on whether there is a causal relationship 

between the diagnosed condition and the employment injury must be based on a complete factual 

2

Id.

3

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

ECAB 312 (1988).

4 B.H., Docket No. 20-0777 (issued October 21, 2020); 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).

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

§ 8101(5) (injury defined); 20 C.F.R. §§ 10.5(ee), 10.5(q) (traumatic injury and occupational disease defined, 

respectively).

6 R.P., Docket No. 21-1189 (issued July 29, 2022); E.M., Docket No. 18-1599 (issued March 7, 2019); RobertG. 

Morris, 48 ECAB 238 (1996).
4

and medical background.7 Additionally, the physician’s opinion must be expressed in terms of a 

reasonable degree of medical certainty and must be supported by medical rationale, explaining the 

nature of the relationship between the diagnosed condition and appellant’s employment injury.8 

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.9

ANALYSIS

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

medical condition in connection with the accepted August 16, 2022 employment incident.

Appellant has not sufficiently established the medical component of her claim. She alleged 

that she sustained a left foot/ankle injury at work when her foot twisted as she stepped off a stair. 

On August 16, 2022 appellant was seen by Dr. Barker. However, the work status note did not 

contain a diagnosis or a rationalized medical opinion explaining the nature of the relationship 

between a diagnosed condition and the accepted employment incident. The Board has held that a

medical report lacking a firm diagnosis and rationalized medical opinion regarding causal 

relationship is of no probative value.10 This report is, therefore, insufficient to establish appellant’s 

claim.

Appellant also submitted multiple work status notes dated September 19 and 26 and

October 4 and 24, 2022 with illegible signatures. The Board has held that medical evidence 

containing an illegible signature, or which is unsigned, has no probative value, as it is not 

established that the author is a physician.11 These reports are, therefore, insufficient to establish 

appellant’s claim.

Further, appellant submitted multiple diagnostic x-rays, CT scans, and MRI scan reports.

However, these diagnostic studies also did not provide a firm diagnosis.12 The Board has also held

that diagnostic studies, standing alone, and lack probative value as they do not address whether 

the employment incident caused any of the diagnosed conditions. 13

7 R.P., id.; F.A., Docket No. 20-1652 (issued May 21, 2021); M.V., Docket No. 18-0884 (issued December 28, 

2018); Victor J. Woodhams, 41 ECAB 345, 352 (1989).

8

Id.

9 T.M., Docket No. 22-0220 (issued July 29, 2022); S.S., Docket No. 18-1488 (issued March 11, 2019); see also

J.L., Docket No. 18-1804 (issued April 12, 2019).

10 J.E., Docket No. 21-0810 (issued April 13, 2023); P.C., Docket No. 18-0167 (issued May 7, 2019).

11 G.D., Docket No. 22-0555 (issued November 18, 2022); see T.C.,Docket No. 21-1123 (issued April5, 2022);

Z.G., 19-0967 (issued October 21, 2019); see R.M., 59 ECAB 690 (2008); MertonJ. Sills, 39 ECAB 572, 575 (1988);

Bradford L. Sullivan, 33 ECAB 1568 (1982).

12 Supra note 10. 

13 A.O., Docket No. 21-0968 (issued March 18, 2022); see M.S., Docket No. 19-0587 (issued July 22, 2019).
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OWCP also received physical therapy progress notes dated October 10 through

November 9, 2022. However, certain healthcare providers such as physician assistants, nurse 

practitioners, physical therapists, and social workers are not considered “physician[s]” as defined 

under FECA and their reports do not constitute competent medical evidence. 14 These notes are 

thus of no probative value and are insufficient to establish appellant’s claim.

As the evidence of record does not include a medical report establishing a firm diagnosed 

medical condition in connection with the accepted August 16, 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 reconsidera tion 

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 August 16, 2022 employment incident.

14 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); 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 H.S., Docket No. 20-0939 (issued February 12, 2021) (physician assistants are not considered 

physicians as defined under FECA). 
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ORDER

IT IS HEREBY ORDERED THAT the February 7, 2023 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: August 29, 2023

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board