United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

L.E., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Nashville, TN, Employer

__________________________________________

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Docket No. 22-1061

Issued: January 23, 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 July 1, 2022 appellant filed a timely appeal from a May 13, 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 to 

consider the merits of this case.2

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, 2021 employment incident. 

1

5 U.S.C. § 8101 et seq.

2 The Board notes that, following the May 13, 2022 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

FACTUAL HISTORY

On August 18, 2021 appellant, then a 39-year-old rural carrier associate, filed a traumatic 

injury claim (Form CA-1) alleging that on August 16, 2021 she sustained lower back pain when 

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

In support of her claim, appellant submitted an August 16, 2021 duty status report (Form 

CA-17) and chart note by Brooke Guillo, a certified physician assistant, a September 3, 2021 

physical therapy referral by Natasha Goins, a nurse practitioner, and an unsigned September 17, 

2021 report from an urgent care clinic.

Appellant also submitted a series of physical therapy treatment notes dated from October 4 

through November 16, 2021. 

In a development letter dated December 10, 2022, OWCP notified appellant of the 

deficiencies of her claim. It advised her of the type of evidence needed and provided a 

questionnaire for her completion. OWCP afforded appellant 30 days to submit the necessary 

evidence. 

In response, OWCP received additional physical therapy treatment notes dated December 1 

and 6, 2021. 

By decision dated January 12, 2022, OWCP accepted that appellant loaded cat litter on 

August 16, 2021, as alleged. However, it denied her claim, finding that the medical evidence of 

record was insufficient to establish a medical diagnosisin connection with the accepted August 16, 

2021 employment incident. OWCP concluded, therefore, that the requirements had not been met 

to establish an injury as defined by FECA. 

Appellant submitted additional physical therapy treatment notes dated from October 13, 

2021 through January 27, 2022. 

On March 8, 2022 appellant requested reconsideration. She submitted additional physical 

therapy treatment notes dated February 2 and 17, 2022.

By decision dated May 13, 2022, OWCP denied modification of its January 12, 2022 

decision.

LEGAL PRECEDENT

An employee seeking benefits under FECA3 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 of FECA,4that 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

20 C.F.R. § 10.607(a).

4 Federal (FECA) Procedure Manual, Part 2 --Claims, Reconsiderations, Chapter 2.1602.4(b) (September 2020).
3

the employment injury.5 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.6

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

OWCP begins with an analysis of whether fact of injury has been established.7 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.8 The second component is whether the employment incident caused a personal injury.9

Rationalized medical opinion evidence is required to establish causal relationship. The 

opinion of the physician must be based on a complete factual and medical background, 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 the specific employment incident. 10 

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.11

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, 2021 employment incident. 

In support of her claim, appellant submitted an August 16, 2021 duty status report (Form 

CA-17) and an August 16, 2021 report by Ms. Guillo, a certified physician assistant, a 

September 3, 2021 physical therapy referral by Ms. Goins, a nurse practitioner, and a series of 

physical therapy treatment notes. The Board has held that medical reports signed solely by a nurse 

practitioner, physician assistant, or physical therapist, however, are of no probative value, as such 

healthcare providers are not considered physicians as defined under FECA and, therefore , are not 

5 G.G., Docket No. 18-1072 (issued January 7, 2019); E.R., Docket No. 09-0599 (issued June 3, 2009); LeonD. 

Faidley, Jr., 41 ECAB 104 (1989).

6

See 20 C.F.R. § 10.607(b); M.H., Docket No. 18-0623 (issued October 4, 2018); Charles J. Prudencio, 41 ECAB 

499, 501-02 (1990).

7 L.C., Docket No. 18-1407 (issued February 14, 2019); M.L., Docket No. 09-0956 (issued April15, 2010). See 

also 20 C.F.R. § 10.607(b);supranote 4 at Chapter 2.1602.5 (September 2020).

8

J.W., Docket No. 18-0703 (issued November 14, 2018); RobertG. Burns, 57 ECAB 657 (2006).

9

J.S., Docket No. 16-1240 (issued December 1, 2016);supra note 4 at Chapter 2.1602.5(a)(September 2020).

10 S.S., Docket No. 18-1488 (issued March 11, 2019).

11 T.M., Docket No. 22-0220 (issued July 29, 2022); J.L., Docket No. 18-1804 (issued April12, 2019).
4

competent to provide a medical opinion.12 Therefore, this evidence is insufficient to establish 

appellant’s claim.

Appellant also provided an unsigned September 17, 2021 report from an urgent care 

provider. The Board has held that reports that are unsigned or bear an illegible signature lack 

proper identification and cannot be considered probative medical evidence as the author cannot be 

identified as a physician.13 Accordingly, this report is also insufficient to establish appellant’s 

claim.

As the medical evidence of record does not contain a medical report relating a diagnosed 

medical condition to the accepted August 16, 2021 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 August 16, 2021 employment incident. 

12 Section 8102(2) of FECA provides as follows: (2) 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. § 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 

individuals such as physician assistants, nurses, and physical therapists are 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); J.D., Docket No. 21-0164 (issued June15, 2021) 

(nurse practitioners are not physicians as defined under FECA).

13 A.H., Docket No. 22-0001 (issued July 29, 2022); M.A., Docket No. 19-1551 (issued April 30, 2020); T.O., 

Docket No. 19-1291 (issued December 11, 2019); MertonJ. Sills, 39 ECAB 572, 575 (1988).
5

ORDER

IT IS HEREBY ORDERED THAT the May 13, 2022 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: January 23, 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