United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

J.B., Appellant

and

U.S. POSTAL SERVICE, JOHNSTON POST 

OFFICE, Johnston, RI, Employer

__________________________________________

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Docket No. 23-0884

Issued: January 22, 2024

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 June 8, 2023 appellant filed a timely appeal from a December 12, 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.

2

ISSUE

The issue is whether appellant has met his burden of proof to establish a medical condition

causally related to the accepted October 19, 2022 employment incident.

1

5 U.S.C. § 8101 et seq.

2 The Board notes that, following the December 12, 2022 decision, OWCP received additional evidence. 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 October 24, 2022 appellant, then a 48-year-old rural delivery specialist, filed a 

traumatic injury claim (Form CA-1) alleging that on October 19, 2022 he injured his back, head, 

neck, left arm, and left elbow and experienced a headache and lethargy when the motor vehicle he 

was operating was rearended while in the performance of duty. He stopped work on that date.

In an October 26, 2022 development letter, OWCP informed appellant of the deficiencies 

of his claim. It advised him of the factual and medical evidence necessary to establish his claim 

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

necessary evidence. 

Thereafter, appellant submitted an October 19, 2022 visit note from Cassandra Aubin, a 

nurse practitioner, noting that appellant was struck from behind while delivering mail and that his 

arm was outside the truck when he got hit, causing neck pain, brain fog, and left elbow pain. She 

assessed a contusion of the left elbow, motor vehicle accident, motor vehicle accident injuring a 

restrained driver, acute cervical strain, and brain fog. 

In visit notes dated October 21, 25, and November 4, 2022, Mladen Kolovrat, a physician 

assistant, performed a physical examination and diagnosed an acute cervical strain, left elbow 

contusion, brain fog, and motor vehicle accident. 

In physical therapy notes dated October 21 through November 10, 2022, Yoshimitsu 

Denison, a physical therapist, treated appellant and noted a diagnosis of an acute cervical strain 

and a contusion of the left elbow. 

In duty status reports(Form CA-17) dated November 9 and 10, 2022, healthcare providers, 

whose signatures are illegible, indicated that appellant injured his elbow and back in an 

October 19, 2022 accident, diagnosed a cervical strain, and returned him to work on 

November 10, 2022.

In a November 10, 2022 visit note, Dr. Steven Ritucci, Jr., an osteopath specializing in 

physiatry, treated appellant and assessed a cervical strain. In a work status report of even date, he 

diagnosed a cervical strain and returned appellant to work on that date with restrictions. 

By decision dated November 28, 2022, OWCP accepted that the October 19, 2022 

employment incident occurred as alleged. However, it denied appellant’s traumatic injury claim, 

finding that the evidence of record was insufficient to establish causal relationship between his 

diagnosed medical conditions and the accepted October 19, 2022 employment incident.

OWCP continued to receive evidence, including a November 17, 2022 visit note from

Dr. Ritucci noting a diagnosis of cervical strain. 

On December 6, 2022 appellant requested reconsideration of the November 28, 2022 

decision and submitted additional evidence. 

In an undated note, Dr. Ritucci related that appellant was involved in an October 19, 2022 

accident in which his mail truck was rear-ended while his arm was outside the vehicle, resulting 

in left-sided neck pain that had persisted for 43 days. He noted that appellant’s condition had 

improved with physical therapy, but he continued to have issues with neck mobility, which may 
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impair his driving. Dr. Ritucci opined that appellant’s symptoms were “certainly from the accident 

and that all [medical] orders ... given pertinent to his care should be considered a direct result of 

the accident.”

In a November 23, 2022 visit note, Dr. Ritucci performed a physical examination and 

diagnosed a cervical strain and motor vehicle accident. He returned appellant to work on that date 

with physical restrictions of no driving and lifting a maximum of 35 pounds. 

In a November 28, 2022 response to OWCP’s developmental questionnaire, appellant 

noted that he was placing mail into a mailbox located on a pole when he was rear-ended by a 

vehicle that impacted him so forcefully that he was unable to remember what he struck his arm on. 

He related that he experienced neck, back, and elbow pain and sought medical treatment after the 

incident. 

By decision dated December 12, 2022, OWCP denied modification of its November 28, 

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 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 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 whether a federal employee has sustained a traumatic injury in the 

performance of duty, it first must be determined whether fact of injury has been established. There 

are two components involved in establishing fact of injury. The first component is whether he or 

she actually experienced the employment incident at the time and place, and in the manner alleged. 

The second component is whether the employment incident caused an injury and can be 

established only by medical evidence.7

3

Supra note 1.

4 F.H., Docket No.18-0869 (issued January 29, 2020); J.P., Docket No. 19-0129 (issued April26, 2019); JoeD. 

Cameron, 41 ECAB 153 (1989). 

5 L.C., Docket No. 19-1301 (issued January 29, 2020); J.H., Docket No. 18-1637 (issued January 29, 2020); 

James E. Chadden, Sr., 40 ECAB 312 (1988).

6 P.A., Docket No. 18-0559 (issued January 29, 2020); K.M., Docket No. 15-1660 (issued September 16, 2016); 

Delores C. Ellyett, 41 ECAB 992 (1990).

7 T.H., Docket No. 19-0599 (issued January 28, 2020); K.L., Docket No. 18-1029 (issued January 9, 2019); John J. 

Carlone, 41 ECAB 354 (1989).
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The medical evidence required to establish causal relationship between a claimed specific 

condition and an employment incident is rationalized medical opinion evidence. 8 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 the specific employment incident 

identified by the claimant.9

ANALYSIS

The Board finds that appellant has met his burden of proof to establish a contusion of the 

left elbow causally related to the accepted October 19, 2022 employment incident.

OWCP found that the October 19, 2022 employment incident occurred as alleged. In an 

October 19, 2022 visit note, Ms. Aubin, a nurse practitioner, observed a contusion of the left elbow 

from the accepted employment incident. As the evidence of record establishes that appellant’s 

employment incident resulted in a visible injury, the Board finds that he met his burden of proof 

to establish a contusion of the left elbow causally related to the accepted October 19, 2022 

employment incident.10 The case will, therefore, be remanded for payment of medical expenses 

for appellant’s contusion of the left elbow, to be followed by a de novo decision regarding any 

attendant disability.

The Board further finds, however, that appellant has not met his burden of proof to establish 

additional medical conditions causally related to the accepted October 19, 2022 employment 

injury.

Appellant submitted an undated note from Dr. Ritucci noting that he was involved in an 

October 19, 2022 accident in which his mail truck was rear-ended while his arm was outside the 

vehicle, resulting in left-sided neck pain. Dr. Ritucci opined that his symptoms were “certainly 

from the accident and that all [medical] orders ... given pertinent to his care should be considered 

a direct result of the accident.” The Board has held that medical evidence that merely states a 

conclusion but does not offer a medically sound and rationalized explanation by the physician of 

how the accepted employment incident physiologically caused or aggravated the diagnosed 

conditions, is of limited probative value on the issue of causal relationship. 11 Dr. Ritucci’s report 

did not provide sufficient medical rationale explaining the basis of his conclusory opinion that 

8

S.S., Docket No. 19-0688 (issued January 24, 2020); A.M., Docket No. 18-1748 (issued April24, 2019); RobertG. 

Morris, 48 ECAB 238 (1996).

9 A.S., Docket No. 19-1955 (issued April 9, 2020); Leslie C. Moore, 52 ECAB 132 (2000).

10 See Federal (FECA) Procedure Manual, Part 2 -- Claims, Initial Development of Claims, Chapter 2.800.6a 

(June 2011); Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.805.3c 

(January2013). See also A.W., Docket No. 22-1196 (issued November 23, 2022); J.S., Docket No. 21-0376 (issued 

September 16, 2022); A.J.,Docket No. 20-0484 (issued September 2, 2020); S.K.,Docket No. 18-1411 (issued 

July 22, 2020).

11 J.B., Docket No. 21-0011 (issued April 20, 2021); A.M., Docket No. 19-1394 (issued February 23, 2021).
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appellant’s medical conditions were caused by the accepted employment incident. 12 The Board 

has also held that a medical report is of no probative value if it does not provide a firm diagnosis 

of a particular medical condition.13 Dr. Ritucci did not diagnose a medical condition in this report. 

As such, this evidence is insufficient to establish appellant’s claim.14

Appellant also submitted a November 10, 2022 work status note, and visit notes dated 

November 10, 17, and 23, 2022, in which Dr. Ritucci treated appellant and diagnosed an acute 

cervical strain and motor vehicle accident. However, Dr. Ritucci did not provide an opinion on 

causal relationship in these notes. The Board has consistently held that medical evidence which 

does not offer an opinion regarding the cause of an employee’s condition is of no probative value 

on the issue of causal relationship. As such, these reports are insufficient to meet appellant’s 

burden of proof.15

OWCP also received an October 19, 2022 visit note from Ms. Aubin, a nurse practitioner,

and visit notes dated October 21, 25, and November 4, 2022 from Mr. Kolovrat, a physician 

assistant. Additionally, OWCP received physical therapy notes dated October 21 through 

November 10, 2022 from Mr. Denison, a physical therapist. However, the Board has long held 

that certain healthcare providers such as nurse practitioners, physician assistants, and physical 

therapists are not considered qualified “physician[s]” as defined under FECA and their findings, 

reports and/or opinions will not suffice for purposes of establishing entitlement to FECA 

benefits.16 Accordingly, these reports are insufficient to satisfy appellant’s burden of proof.17

The remaining medical evidence of record consists of CA-17 forms dated November 9 

and 10, 2022 from healthcare providers, whose signatures are illegible, diagnosing a cervical 

strain. However, the Board has long held that reports that bear an illegible signature lack proper 

12 R.T., Docket No. 17-1230 (issued May 3, 2018);T.M., Docket No. 08-0975 (issued February 6, 2009) (a medical 

report is of limited probative value on the issue of causal relationship if it contains a conclusion regarding causal 

relationship which is unsupported by medical rationale).

13 A.R., Docket No. 19-1560 (issued March 2, 2020); V.B., Docket No. 19-0643 (issued September 6, 2019).

14 Id.

15 See D.Y., Docket No. 20-0112 (issued June 25, 2020); L.B., Docket No. 18-0533 (issued August 27, 2018); D.K., 

Docket No. 17-1549 (issued July 6, 2018).

16 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. § 8101(2); 20 C.F.R. § 10.5(t). See Federal (FECA) Procedure Manual, Part 2 -- Claims, 

Causal Relationship, Chapter 2.805.3a(1) (September 2020); 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 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); J.D., Docket No. 21-0164 (issued 

June 15, 2021) (nurse practitioners are not physicians as defined under FECA); A.M., Docket No. 20-1575 (issued 

May 24, 2021) (physical therapists are not physicians as defined by FECA).

17 R.H., Docket No. 21-1382 (issued March 7, 2022); S.E., Docket No. 21-0666 (issued December 28, 2021).
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identification and cannot be considered probative medical evidence as the author cannot be 

identified as a physician.18

As appellant has not submitted rationalized medical opinion evidence establishing 

additional medical conditions causally related to the accepted October 19, 2022 employment 

injury, 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.

CONCLUSION

The Board finds that appellant has met his burden of proof to establish a contusion of the 

left elbow causally related to the accepted October 19, 2022 employment incident. The Board 

further finds, however, that appellant has not met his burden of proof to establish additional 

medical conditions causally related to the accepted October 19, 2022 employment injury.

ORDER

IT IS HEREBY ORDERED THAT the December 12, 2022 decision of the Office of 

Workers’ Compensation Programs is reversed in part and affirmed in part.

Issued: January 22, 2024

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

18 L.B., Docket No. 21-0353 (issued May 23, 2022); T.D., Docket No. 20-0835 (issued February 2, 2021); Merton J. 

Sills, 39 ECAB 572, 575 (1988).