United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

S.I., Appellant

and

DEPARTMENT OF VETERANS AFFAIRS, 

EDWARD HINES, JR. VA HOSPITAL, 

Hines, IL, Employer

__________________________________________

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Docket No. 22-0538

Issued: October 3, 2022

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

JANICE B. ASKIN, Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On February 18, 2021 appellant filed a timely appeal from an October 25, 2021 merit 

decision and a December 23, 2021 nonmerit 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

1

5 U.S.C. § 8101 et seq.

2 The Board notes that, following the December 23, 2021 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

ISSUES

The issues are: (1) whether appellant has established a medical condition causally related 

to the accepted July 28, 2021 employment incident; and (2) whether OWCP properly denied 

appellant’s request for an oral hearing as untimely filed, pursuant to 5 U.S.C. § 8124(b).

FACTUAL HISTORY

On August 25, 2021 appellant, then a 61-year-old medical supply aid and technician, filed 

a traumatic injury claim (Form CA-1) alleging that on July 28, 2021 he injured his leg when he 

tripped over an electrical outlet sticking out of the floor while in the performance of duty. He 

explained that he was carrying a surgical tray at the time. On the reverse side of the claim form,

appellant’s supervisor indicated that he was not injured in the performance of duty because he had 

been instructed not to sit at the back-end table to prevent injury as the workstation was not 

functioning due to computer issues.

In support of his claim, appellant submitted a partial emergency department report dated 

July 28, 2021 from Dr. Bernadette B. Gniadecki, Board-certified in emergency medicine, whose 

physical examination of the right lower extremity revealed tenderness in the anterior mid-upper 

leg. X-ray scans of the right femur, pelvis, and right hip revealed no fracture or dislocation. 

Dr. Gniadecki diagnosed acute right upper leg strain. She advised that appellant should be off 

work and recommended ice and rest. In a work excuse note of even date, Dr. Gniadecki advised 

that appellant should be off work pending clearance by the employing establishment’s healthcare 

unit.

In a July 30, 2021 occupational medicine report, Timothy R. Newcomb, a physician 

assistant, related that appellant injured his right hip and low back on July 28, 2021 at work when 

he tripped on a floor outlet and fell in a split, hyperextending his right hip. Appellant rep orted 

feeling stinging pain in the right anterior hip and right lumbar region and continued to have 

persistent pain and stiffness in the right hip and low back, especially with walking, sitting, and 

pivoting. Mr. Newcomb’s examination revealed guarded gait with use of axial crutches, range of 

motion (ROM) limited by pain in forward bend, extension, lateral flexion, and rotation, normal 

right hip ROM with pain in all planes of motion, and tenderness to palpation in the right proximal 

femur and iliac crest. He diagnosed right hip and low back injury, likely a strain of hip flexor, 

quad lumborum, and pelvis. In an employing establishment emergency treatment report of even 

date, Mr. Newcomb diagnosed right hip and low back injury and checked a box indicating that the 

condition was work related. He advised that appellant could not return to work.

An August 3, 2021 medical report from Dr. Sowmya Mikkilineni, a Board-certified 

geriatrician, related that appellant fell at work on July 28, 20201 when he tripped on an outlet 

projecting out of the floor, falling forward and doing the splits. Appellant reported pain in the

right hip and thigh anteriorly, lower and upper back pain, and right leg pain. Dr. Mikkilineni’s 

examination revealed tenderness over the right thigh and mild tenderness over the lumbosacral 

spine. She noted that appellant came in on crutches and recommended a rollator and bathroom 

equipment. In a work excuse note of even date, Dr. Mikkilineni noted that appellant had an acute 

musculoskeletal injury from a fall at work. She recommended that appellant remain off work for 

30 days given his level of pain and limited ROM.
3

In an August 29, 2021 Occupational Safety and Health Administration (OSHA) injury and 

illness incident report (OSHA Form 301), appellant reported that on July 28, 2021 he retrieved a 

medical tray to process and tripped over an electrical outlet in the floor. He reported that he 

sustained a muscle strain in his leg and low back pain.

OWCP also received an August 29, 2021 statement from D.W., a coworker, relating that 

on the morning of July 28, 2021, appellant informed him that he was injured. He stated that he 

did not witness the incident that led to the injury, but that appellant stated that he was going to the 

emergency room. An August 30, 2021 statement bearing an illegible signature indicated that the 

author did not witness appellant’s July 28, 2021 accident. An August 30, 2021 e-mail from M.T., 

indicates that on July 26, 2021 appellant was informed not to sit at the back-end table because

another employee was electrocuted on June 7, 2021 due to the junction box sticking out of the 

ground.

In a September 8, 2021 work excuse note, Dr. Mikkilineni noted that appellant was 

receiving treatment for an acute musculoskeletal injury from a fall at work and continued to have 

significant pain with movement. She held him off work until his pain and ROM improved and he 

made good progress with physical therapy.

In a September 14, 2021 statement, R.N., a human resources specialist, challenged 

appellant’s claim due to a lack of medical evidence.

In an October 8, 2021 development letter, OWCP informed appellant of the deficiencies of 

his claim. It advised him as to the type of factual and medical evidence required and provided a 

questionnaire for his completion. OWCP afforded appellant 30 days to respond.

OWCP subsequently received a September 20, 2021 medical report from Dr. Mikkilineni, 

relating that appellant hurt himself over the summer when he tripped over a socket in the floor at 

work and that he continued to have thigh, buttocks, and back pain. Examination revealed that 

appellant was walking with a cane and had decreased strength in the right lower extremity due to 

pain. Dr. Mikkilineni diagnosed low back and neck pain.3

In an October 20, 2021 letter, Dr. Mikkilineni related appellant’s history of injury and 

treatment and reviewed October 19, 2021 diagnostic reports. She concluded that “[g]iven [the] 

temporal relation of pain starting after the fall, the pain/limitations of movement were related to 

the fall at work.” In a Family and Medical Leave Act form of even date, Dr. Mikkilineni indicated 

that appellant would be incapacitated and unable to work until approximately December 1, 2021.

3 On October 19, 2021 appellant underwent a pelvic x-ray,which revealed no abnormalities. A pelvic computerized 

tomography (CT) scan taken the same day demonstrated no acute abnormalities and mildly enlarged left inguinal 

lymph node of uncertain etiology and clinical significance. A magnetic resonance imaging (MRI)scanof the lumbar 

spine also taken that day demonstrated intact lumbar spine vertebral bodies without evidence of acute compression 

fracture, mild lumbar spine degenerative disc and facet disease, and mild bilateral neural foraminal narrowing at L4-

L5.
4

By decision dated October 25, 2021, OWCP denied appellant’s traumatic injury claim, 

finding that the evidence of record was insufficient to establish that his medical condition was 

causally related to the accepted July 28, 2021 employment incident.

OWCP continued to receive medical evidence.

In a November 17, 2021 memorandum of telephone call (Form CA-110), OWCP noted 

that appellant had called and inquired regarding the status of his case, as he had not received a 

decision by mail. Appellant indicated that the decision could be resent to the same address OWCP 

had on file.

By appeal request form postmarked December 10, 2021, appellant requested an oral 

hearing before a representative of OWCP’s Branch of Hearings and Review. He provided 

additional evidence in support of his claim.

By decision dated December 23, 2021, OWCP denied appellant’s request for an oral 

hearing, finding that the request was not made within 30 days of the October 25, 2021 decision 

and, therefore, was untimely filed. It further exercised discretion and determined that the issue in 

this case could equally well be addressed by a request for reconsideration before OWCP along 

with the submission of new evidence.

LEGAL PRECEDENT -- ISSUE 1

An employee seeking benefits under FECA4 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, that the claim was timely filed within the applicable 

time limitation period 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 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 at the time and 

4

Supra note 1.

5

S.S., Docket No. 19-1815 (issued June26, 2020); S.B., Docket No. 17-1779 (issued February 7, 2018); JoeD. 

Cameron, 41 ECAB 153 (1989).

6 M.H., Docket No. 19-0930 (issued June 17, 2020); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40 ECAB 

312 (1988).

7

S.A., Docket No. 19-1221 (issued June 9, 2020); L.M., Docket No. 13-1402 (issued February 7, 2014); DeloresC. 

Ellyett, 41 ECAB 992 (1990).
5

place and in the manner alleged.

8

 The second component is whether the employment incident 

caused a personal injury.9

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

condition and an employment incident is rationalized medical opinion evidence.10 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.11

ANALYSIS -- ISSUE 1

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

condition causally related to the accepted February 11, 2021 employment incident.

In an October 20, 2021 letter, Dr. Mikkilineni opined that “[g]iven [the] temporal relation 

of pain starting after the fall, the pain/limitations of movement were related to the fall at work.” 

While she provided an affirmative opinion suggestive of causal relationship, she did not offer 

medical rationale sufficient to explain why she believed appellant’s employment duties could have 

resulted in or contributed to his diagnosed conditions. Without identifying specific employment 

duties or explaining how they caused or aggravated appellant’s conditions, this medical report is

of limited probative value, and is insufficient to meet appellant’s burden of proof.12

In an August 3, 2021 report, Dr. Mikkilineni related that appellant fell at work on July 28, 

2021 when he tripped on an outlet projecting out of the floor, falling forward and doing the splits. 

In a work excuse note of even date, she noted that appellant had an acute musculoskeletal injury 

from a fall at work. In a September 8, 2021 work excuse note, Dr. Mikkilineni indicated that 

appellant was receiving treatment for an acute musculoskeletal injury from a fall at work and 

continued to have significant pain with movement. In a September 20, 2021 medical report, she

related that he hurt himself over the summer when he tripped over a socket in the floor at work 

and diagnosed low back and neck pain. Although Dr. Mikkilineni suggested a work-related cause 

for appellant’s medical condition in each report, she did not provide a rationalized medical opinion 

relating the specific diagnosed condition to the July 28, 2021 employment incident. The Board 

has held that a report is of limited probative value regarding causal relationship if it does not 

contain medical rationale explaining how an employment activity could have caused or aggravated 

8 R.K., Docket No. 19-0904 (issued April10, 2020); Elaine Pendleton, 40 ECAB 1143 (1989).

9 Y.D., Docket No. 19-1200 (issued April6, 2020); John J. Carlone, 41 ECAB 354 (1989).

10 S.S., Docket No. 19-0688 (issued January 24, 2020); A.M., Docket No. 18-1748 (issued April 24, 2019); 

Robert G. Morris, 48 ECAB 238 (1996).

11 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).

12 See A.P., Docket No. 19-0224 (issued July 11, 2019).
6

a medical condition.13 Therefore, these reports are insufficient to establish appellant’s traumatic 

injury claim.

In a July 28, 2021 emergency department report, Dr. Gniadecki diagnosed acute right 

upper leg strain and advised that appellant should be off work. In a work excuse note of even date, 

she advised that appellant should be off work pending clearance by the employing establishment’s 

healthcare unit. In an October 20, 2021 FMLA form, Dr. Mikkilineni indicated that appellant 

would be incapacitated and unable to work until approximately December 1, 2021. However, 

neither Dr. Gniadecki nor Dr. Mikkilineni offered an opinion on causal relationship in any of this 

evidence. The Board has held that medical evidence that does not offer an opinion regarding the 

cause of an employee’s condition is of no probative value on the issue of causal relationship. 14 For 

this reason, this medical evidence is insufficient to meet appellant’s burden of proof.

The remaining medical evidence consists of medical records by Mr. Newcomb, a physician 

assistant. The Board has held that medical reports signed solely by a physician assistant, registered 

nurse, or medical assistant are of no probative value as such healthcare providers are not considered 

physicians as defined under FECA and are, therefore, not competent to provide medical opinions. 15 

Consequently, their medical findings and/or opinions will not suffice for the purpose of 

establishing entitlement to FECA benefits.

As appellant has not submitted rationalized medical evidence establishing that his medical 

condition is causally related to the accepted July 28, 2021 employment incident, the Board finds 

that he has not met his burden of proof to establish his 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.

LEGAL PRECEDENT -- ISSUE 2

Section 8124(b)(1) of FECA provides that “a claimant for compensation not satisfied with 

a decision of the Secretary is entitled, on request made within 30 days after the date of the issuance 

of the decision, to a hearing on his [or her] claim before a representative of the Secretary.”

16

 

13 Y.D., Docket No. 16-1896 (issued February 10, 2017).

14 S.J., Docket No. 19-0696 (issued August23, 2019); M.C., Docket No. 18-0951 (issued January 7, 2019); L.B., 

Docket No. 18-0533 (issued August27, 2018); D.K., Docket No. 17-1549 (issued July 6, 2018).

15 Section § 8102(2) of FECA provides as follows: (2) physician includessurgeons, podiatrists, dentists, clinical 

psychologists, optometrists, chiropractors, and osteopathic practitioners within the scope of their practice as defined 

by State law. 5 U.S.C. § 8102(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 

individualssuch as physician assistants, nurses, and physical therapistsare not competent to render a medical opinion 

under FECA); see also S.S., Docket No. 21-1140 (issued June 29, 2022) (physician assistants are not considered 

physicians under FECA and are not competent to provide medical opinions); George H. Clark, 56 ECAB 162 (2004) 

(physician assistants are not considered physicians under FECA).

16 5 U.S.C. § 8124(b)(1).
7

Sections 10.617 and 10.618 of the federal regulations implementing this section of FECA provide 

that a claimant shall be afforded a choice of an oral hearing or a review of the written record by a 

representative of the Secretary.17 A claimantis entitled to a hearing or review of the written record 

as a matter of right only if the request is filed within the requisite 30 days as determined by 

postmark or other carrier’s date marking and before the claimant has requested reconsideration. 18 

Although there is no right to a review of the written record or an oral hearing if not requested 

within the 30-day time period, OWCP may within its discretionary powers grant or deny 

appellant’s request and must exercise its discretion.19

ANALYSIS -- ISSUE 2

The Board finds that OWCP properly denied appellant’s request for an oral hearing as 

untimely filed, pursuant to 5 U.S.C. § 8124(b).

OWCP’s regulations provide that a request for an oral hearing must be made within 30 

days of the date of the decision for which a review is sought. 20 Appellant, therefore. had 30 days 

following OWCP’s October 25, 2021 merit decision to request an oral hearing before a 

representative of OWCP’s Branch of Hearings and Review. As appellant’s request for an oral 

hearing was postmarked December 10, 2021, more than 30 days after OWCP’s October 25, 2021

decision, it was untimely filed and he was, therefore, not entitled to an oral hearing as a matter of 

right.21

OWCP also has the discretionary power to grant an oral hearing or review of the written 

record even if the claimant is not entitled to review as a matter of right. The Board finds that 

OWCP, in its December 23, 2021 decision, properly exercised its discretion by determining that 

the issue in the case could be equally well addressed through a request for reconsideration before 

OWCP, along with the submission of additional evidence. 

The Board has held that as the only limitation on OWCP’s authority is reasonableness, 

abuse of discretion is generally shown through proof of manifest error, clearly unreasonable 

exercise of judgment, or actions taken which are contrary to both logic and probable deduction 

from established facts.22 In this case, OWCP did not abuse its discretion by denying appellant’s 

17 20 C.F.R. §§ 10.616, 10.617.

18 Id. at § 10.616(a).

19 See A.M., Docket No. 21-0256 (issued July 22, 2021);W.H., Docket No. 20-0562 (issued August 6, 2020); P.C., 

Docket No. 19-1003 (issued December 4, 2019); M.G., Docket No. 17-1831 (issued February 6, 2018); Eddie 

Franklin, 51 ECAB 223 (1999); Delmont L. Thompson, 51 ECAB 155 (1999).

20 Supra note 18.

21 Federal (FECA) Procedure Manual, Part 2 -- Claims, Hearings and Reviews of the Written Record, Chapter 

2.1601.4a (September 2020);see W.N., Docket No. 20-1315 (issued July 6, 2021);see also G.S., Docket No. 18-0388 

(issued July 19, 2018).

22 See T.G., Docket No. 19-0904 (issued November 25, 2019); Daniel J. Perea, 42 ECAB 214 (1990).
8

request for an oral hearing. Accordingly, the Board finds that OWCP properly denied her request 

for an oral hearing, as untimely filed, pursuant to 5 U.S.C. § 8124(b)(1).

CONCLUSION

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

condition causally related to the accepted July 28, 2021 employment incident. The Board further 

finds that OWCP properly denied his request for an oral hearing as untimely filed, pursuant to 5 

U.S.C. § 8124(b).

ORDER

IT IS HEREBY ORDERED THAT the October 25 and December 23, 2021 decisions of 

the Office of Workers’ Compensation Programs are affirmed.

Issued: October 3, 2022

Washington, DC

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board