United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

R.W., Appellant

and

DEPARTMENT OF VETERANS AFFAIRS, 

GREATER LOS ANGELES HEALTHCARE 

SYSTEM, Los Angeles, CA, Employer

__________________________________________

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Docket No. 22-0043

Issued: April 25, 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

JANICE B. ASKIN, Judge

JURISDICTION

On October 4, 2021 appellant timely filed for review of an April 9, 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 to 

consider the merits of this case.

ISSUE

The issue is whether appellant has met his burden of proof to establish a diagnosed foot 

condition causally related to the accepted factors of his federal employment.

FACTUAL HISTORY

On September 9, 2020 appellant, then a 54-year-old nursing assistant, filed an occupational 

disease claim (Form CA-2) alleging that he developed torn tendons in both feet as a result of 

1

5 U.S.C. § 8101 et seq.
2

transferring heavy patients from a chair to the bed or gurney and turning them for cleaning while 

in the performance of duty. He noted that he became aware of his condition on June 1, 2001 and 

realized that it was caused or aggravated by his federal employment on February 18, 2020.2 

Appellant did not stop work. Appellant’s supervisor noted on the claim form that appellant had 

been detailed to light duty. 

In support of his claim, appellant submitted a February 18, 2020 progress note signed by

Dr. Lina Salty, a Board-certified internist. Dr. Salty noted that appellant could work with 

permanent restrictions of no carrying more than 30 pounds and no engaging in stooping/bending 

activity. She advised that his existing condition was aggravated by his work. Dr. Salty concluded

that appellant was permanently moderately disabled due to his incapacitating injury or disease.

In an August 20, 2020 form report, Alma Magana, a family nurse practitioner, noted that 

appellant had chronic insomnia and sleep apnea with delayed sleep phase. In a request for medical 

documentation of even date, she requested that he be provided reasonable accommodations of: no 

pushing gurneys; no lifting more than 30 pounds; no stooping or bending; and no standing more 

than two hours. Ms. Magana also noted it was not recommended that appellant perform fast paced 

work due to diagnosis of short segment longitudinal split tear of the peroneus brevis tendon below 

the lateral malleolus, and chronic back pain. 

Appellant also submitted his written confirmation of request for accommodation dated 

August 26, 2020 and reassignment notices issued by the employing establishment on January 16 

and February 18, 2020.

In an August 26, 2020 letter, the employing establishment indicated that appellant was 

receiving service-connected disability compensation and that he was 90 percent disabled.

OWCP, in a September 30, 2020development letter, informed appellant of the deficiencies 

of his claim. It advised him of the type of factual and medical evidence needed and provided a 

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

evidence.

OWCP received a copy of Dr. Salty’s previously submitted February 18, 2020 progress 

note.

By decision dated December 15, 2020, OWCP denied appellant’s occupational disease 

claim, finding that the medical evidence of record was insufficient to establish a diagnosed medical 

condition causally related to the accepted factors of his federal employment.

On January 12, 2021 appellant requested a review of the written record by a representative 

of OWCP’s Branch of Hearings and Review.

By decision dated April 9, 2021, the hearing representative affirmed the December 15, 

2020 decision.

2 Appellant also noted that he was a 90 percent service-connected disabled veteran. 
3

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 period 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 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

OWCP’s regulations define the term “occupational disease or illness” as a condition 

produced by the work environment over a period longer than a single workday or shift. ”

7

 To 

establish that an injury was sustained in the performance of duty in an occupational disease claim, 

a claimant must submit the following: (1) a factual statement identifying employment factors 

alleged to have caused or contributed to the presence or occurrence of the disease or condition; 

(2) medical evidence establishing the presence or existence of the disease or condition for which 

compensation is claimed; and (3) medical evidence establishing that the diagnosed condition is 

causally related to the identified employment factors.8

Causal relationship is a medical question that requires rationalized medical opinion 

evidence to resolve the issue.9 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 diagnosed 

condition and the specific employment factors identified by the claimant. 10

3

Id.

4

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).

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

312 (1988).

6

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).

7

20 C.F.R. § 10.5(ee).

8 R.G., Docket No. 19-0233 (issued July 16, 2019). See also Roy L. Humphrey, 57 ECAB 238, 241 (2005); Ruby I. 

Fish, 46 ECAB 276, 279 (1994); Victor J. Woodhams, 41 ECAB 345 (1989).

9 L.F., Docket No. 19-1905 (issued April10, 2020); Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000).

10 A.S., Docket No. 19-1955 (issued April9, 2020);LeslieC. Moore, 52 ECAB 132 (2000).
4

ANALYSIS

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

condition causally related to the accepted factors of his federal employment.

In a February 18, 2020 progress note, Dr. Salty found that appellant had an incapacitating 

injury or disease aggravated by his work, resulting in permanent moderate disability. She noted 

however, that he could work with permanent restrictions. While Dr. Salty offered an opinion on 

causal relationship, she did not provide a firm medical diagnosis as she only related an 

“incapacitating injury or disease”

11

 Further, she did not explain how physiologically the accepted 

employment factors caused a diagnosed condition.

12

 For these reasons, the Board finds that this 

evidence is insufficient to establish appellant’s burden of proof.

The note from Ms. Magana, a family nurse practitioner, does not constitute competent 

medical evidence because nurse practitioners are not considered physicians as defined under 

FECA.13 Consequently, their medical findings and/or opinions are of no probative value and will 

not suffice for purposes of establishing entitlement to compensation benefits. 14

As the record does not contain rationalized medical opinion evidence sufficient to establish 

a diagnosed foot condition causally related to the accepted factors of appellant’s federal 

employment, the Board finds that appellant has not met his 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 his burden of proof to establish a foot condition 

causally related to the accepted factors of his federal employment.

11 See A.K., Docket No. 20-0003 (issued June 2, 2020); M.M., Docket No. 19-0972 (issued November 18, 2019); 

See J.S.,Docket No. 18-0726 (issued November 5, 2018). 

12 J.F.,Docket No. 18-0492 (issued January16, 2020); M.L.,Docket No. 19-0813 (issued November 26, 2019); see 

B.R., Docket No. 17-0294 (issued May 11, 2018).

13 Section 8101(2) 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 also 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 B.H., Docket No. 20-0268 (issued August 11, 2021) (nurse practitioners are not considered 

physicians under FECA).

14 Id.
5

ORDER

IT IS HEREBY ORDERED THAT the April 9, 2021 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: April 25, 2022

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board