United States Department of Labor

Employees’ Compensation Appeals Board

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K.G., Appellant

and

U.S. POSTAL SERVICE, WEST STATION,

Nashville, TN, Employer

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Docket No. 22-0970

Issued: February 24, 2023

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

PATRICIA H. FITZGERALD, Deputy Chief Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On June 13, 2022 appellant filed a timely appeal from a May 27, 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 his burden of proof to establish a recurrence of 

disability commencing March 2, 2022, causally related to his accepted December 27, 2019

employment injury.

FACTUAL HISTORY

On January 13, 2020 appellant, then a 30-year-old city carrier, filed an occupational disease 

claim (Form CA-2) alleging that he developed right hip pain due to factors of his federal 

1 5 U.S.C. § 8101 et seq.
2

employment, including repeated sitting, reaching, and grabbing. He noted that he first became 

aware of his condition and realized its relation to his federal employment on December 27, 2019. 

OWCP accepted the claim for strain of muscle, fascia, and tendon of the right hip. Appellant 

stopped work on January 7, 2020 and returned to full-duty work without restrictions on 

January 13, 2020.

On March 9, 2022 appellant filed a notice of recurrence (Form CA-2a) for medical 

treatment and time lost from work commencing March 2, 2022 due to the December 27, 2019

employment injury. He noted on the claim form that he started feeling “the same pain” on 

March 1, 2022. Appellant further indicated that he first received medical treatment following the 

alleged March 2, 2022 recurrence and subsequently stopped work on March 9, 2022.

In a development letter dated March 23, 2022, OWCP informed appellant of the 

deficiencies of his recurrence claim. It advised him of the type of additional medical evidence 

needed and provided a questionnaire for his completion. OWCP afforded appellant 30 days to 

respond.

OWCP thereafter received a report dated March 9, 2022 by William Jason, a physician 

assistant, who noted that appellant related complaints of right hip pain, which he attributed to a 

work-related injury. Mr. Jason further noted that he had been working regular duty since 

January 13, 2020, but claimed that his right hip pain had never fully resolved. He performed a 

physical examination and documented subjective complaints of pain in the right lateral hip and 

lumbar regions, but an otherwise normal examination. Mr. Jason diagnosed a right hip sprain and 

prescribed physical therapy and magnetic resonance imaging (MRI) scan of the right hip. He

released appellant to return to work with restrictions of occasional lifting up to 15 pounds and 

occasional pushing and pulling up to 20 pounds. 

Appellant underwent physical therapy treatment on March 17, 18, 21, and 25, 2022.

In a report dated March 21, 2022, Dr. Rebecca Smith, a Board-certified family physician, 

noted that appellant was working modified duty, and that his posterolateral right hip pain had 

improved. She reviewed a recent MRI scan of the right hip and noted mild tendinosis of the gluteus 

minimus with edema overlying the greater trochanteric bursa. Dr. Smith performed a physical 

examination and documented mild tenderness to palpation of the gluteus minimus and greater 

trochanteric bursa and mild pain with extension and abduction against resistance. She diagnosed 

a right hip strain and recommended medication and hot and cold compresses. In a work activity 

status report of even date, Dr. Smith maintained appellant’s modified-duty restrictions.

In a report dated March 25, 2022, Dr. William Dutton, an occupational medicine physician, 

noted that appellant was working modified duty and had completed physical therapy. He 

performed a physical examination, which revealed tenderness in the right gluteus minimus, but 

was otherwise normal. Dr. Dutton diagnosed a right hip strain, released appellant from care, and 

opined that he was able to resume full-work activity.

In a completed development questionnaire dated March 28, 2022, appellant explained that 

he performed hip stretches for two years after his original discharge from treatment. Then, during 

the first week of March 2022, he experienced pain in the same area of his right hip while 
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performing his job duties including constant sitting, stretching, pulling, and bending. Appellant 

denied any intervening injury or hobbies outside of work that would have caused a new injury to 

his right hip. He asserted that his symptoms had worsened due to an increased work schedule due 

to short staffing.

By decision dated May 27, 2022, OWCP denied appellant’s claimed recurrence

commencing March 2, 2022. It found that the medical evidence of record was insufficient to 

establish that he was disabled from work during the claimed period, due to a material change or 

worsening of his December 27, 2019 employment injury.

LEGAL PRECEDENT

A recurrence of disability means an inability to work after an employee has returned to 

work, caused by a spontaneous change in a medical condition which resulted from a previous 

compensable injury or illness and without an intervening injury or new exposure in the work 

environment.2

OWCP’s procedures provide that a recurrence of disability includes a work stoppage 

caused by a spontaneous material change in the medical condition demonstrated by objective 

findings. That change must result from a previous injury or an occupational illness rather than an 

intervening injury or new exposure to factors causing the original illness. It does not include a 

condition that results from a new injury, even if it involves the same part of the body previously 

injured.3

The medical evidence required to establish causal relationship between a claimed period 

of disability and an employment injury is rationalized medical opinion evidence. The opinion of 

the physician must be based on a complete factual and medical background of the claimant, must 

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

nature of the relationship between the claimed disability and the accepted employment injury.

4

 

The Board will not require OWCP to pay compensation for disability in the absence of medical 

evidence directly addressing the specific dates of disability for which compensation is claimed. 

To do so would essentially allow an employee to self-certify their disability and entitlement to 

compensation.5

2 20 C.F.R. § 10.5(x); see W.H., Docket No. 21-0139 (issued October 26, 2021); A.E., Docket No. 20-0259 (issued 

April 28, 2021); J.D., Docket No. 18-1533 (issued February 27, 2019).

3 Federal (FECA) Procedure Manual, Part 2 -- Claims, Recurrences, Chapter 2.1500.2b (June 2013); L.B., Docket 

No. 18-0533 (issued August 27, 2018).

4 See B.D., Docket No. 18-0426 (issued July 17, 2019); Amelia S. Jefferson, 57 ECAB 183 (2005).

5

Id.; Fereideoon Kharabi, 52 ECAB 291 (2001).
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ANALYSIS

The Board finds that appellant has not met his burden of proof to establish a recurrence of 

disability commencing March 2, 2022, causally related to his accepted December 27, 2019

employment injury.

In her March 21, 2022 report, Dr. Smith diagnosed a right hip strain and released appellant 

to return to work with restrictions. Similarly, in his March 25, 2022 report, Dr. Dutton released 

appellant from care and opined that he was capable of performing full-duty work without 

restrictions. However, neither physician provided an opinion regarding the cause of appellant’s 

condition or disability, as such their reports are of no probative value.

6

 Consequently, Dr. Smith’s 

and Dr. Dutton’s reports are insufficient to establish the recurrence claim.

OWCP also received a March 9, 2022 treatment note from a physician assistant and 

physical therapy notes dated March 17 through 25, 2022. Physician assistants and physical 

therapists, however, are not considered physicians as defined under FECA, and their medical 

findings and opinions are insufficient to establish entitlement to compensation benefits.7

As the medical evidence of record is insufficient to establish a recurrence of disability 

commencing March 2, 2022, causally related to the December 27, 2019 employment injury, the 

Board finds that appellant has not met his burden of proof to establish his recurrence claim.

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 10.607.8

6 See L.B., supra note 3; D.K., Docket No. 17-1549 (issued July 6, 2018).

7 Section 8101(2) of FECA provides that a physician includes surgeons, podiatrists, dentists, clinical psychologists, 

optometrists, chiropractors, and osteopathic practitioners within the scope of their practice a s 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); N.C., Docket No. 21-0934 (issued February 7, 2022); M.J., Docket 

No. 19-1287 (issued January 13, 2020) (physician assistants are not considered physicians as defined under FECA); 

P.H., Docket No. 19-0119 (issued July 5, 2019) (physician assistants are not physicians under FECA); T.K., Docket 

No. 19-0055 (issued May 2, 2019) (physical therapists are not considered physicians as defined under FECA); 

David P. Sawchuk, 57 ECAB 316, 320 n.11 (2006) (lay individuals such as nurses, physician assistants, and physical 

therapists are not competent to render a medical opinion under FECA).

8 The Board also notes that the employing establishment issued a Form CA-16 authorization for examination or 

treatment. A 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. See 20 C.F.R. § 10.300(c); J.G., Docket No. 17-1062 (issued February 13, 2018); Tracy P. Spillane, 54 ECAB 

608 (2003).
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CONCLUSION

The Board finds that appellant has not met his burden of proof to establish a recurrence of 

disability commencing March 2, 2022, causally related to his accepted December 27, 2019

employment injury.

ORDER

IT IS HEREBY ORDERED THAT the May 27, 2022 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: February 24, 2023

Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board