United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

M.M., Appellant

and

DEPARTMENT OF VETERANS AFFAIRS,

COLMERY-O’NEIL VA MEDICAL CENTER, 

Topeka, KS, Employer

__________________________________________

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Docket No. 23-0475

Issued: July 27, 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

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On February 21, 2023 appellant filed a timely appeal from a January 31, 2023 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 her burden of proof to establish a diagnosed 

medical condition causally related to the accepted February 8, 2021 employment incident.

FACTUAL HISTORY

On February 8, 2021 appellant, then a 52-year-old custodial worker, filed a traumatic 

injury claim (Form CA-1) alleging that on that date she bruised her ribs when she slipped and 

fell on the left side of her upper torso while in the performance of duty. 

1

5 U.S.C. § 8101 et seq.
2

OWCP, by development letter dated December 28, 2022, informed appellant of the 

deficiencies of her claim. It advised her of the type of factual and medical evidence needed and 

afforded her 30 days to respond. 

OWCP subsequently received a December 8, 2022 progress note by Stephanie K. Haas, a 

registered nurse, and Julie Stanley, an advanced registered nurse practitioner, who related

appellant’s history of injuring her left shoulder which she thought had healed at the end of 

October/beginning of November 2022 and reinjuring her left shoulder on December 5, 2022 

while changing sheets of a bed at work.

A December 5, 2022 left shoulder x-ray provided an impression of no acute bony 

findings. 

A December 8, 2022 left shoulder magnetic resonance imaging (MRI) scan demonstrated 

a marked abnormal thinning of the distal supraspinatus and infraspinatus tendons along with 

elevation of the humeral head and narrowing of the subacromial space, which were findings

compatible with near complete tears of the distal supraspinatus and infraspinatus tendons. There 

were also probable intact fibers involving the anterior aspect of the supraspinatus and posterior 

aspect of the infraspinatus tendons. Additionally, there was marked supraspinatus and 

infraspinatus muscle atrophy compatible with chronic distal tendinous tears; mild-to-moderate 

degenerative change and hypertrophy at the acromioclavicular joint; mild degenerative change at 

the glenohumeral joint; no definite labral tear; and fluid within the sub coracoid bursa that could 

be due to decompressed joint fluid or possibly a mild bursitis.

By decision dated January 31, 2023, OWCP accepted that the February 8, 2021 

employment incident occurred, as alleged, but denied appellant’s claim, finding that the medical 

evidence of record was insufficient to establish a diagnosed medical condition causally related to 

the accepted employment incident. It concluded, therefore, that the requirements had not been 

met to establish an injury as defined by FECA. 

LEGAL PRECEDENT

An employee seeking benefits under FECA2 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,3that 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 

2

Id.

3 V.L., Docket No. 20-0884 (issued February 12, 2021); F.H., Docket No. 18-0869 (issued January 29, 2020); 

J.P., Docket No. 19-0129 (issued April 26, 2019); Joe D. Cameron, 41 ECAB 153 (1989).
3

employment injury.4 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.5

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 that the 

employee must submit sufficient evidence to establish that he or she actually experienced the 

employment incident at the time, place, and in the manner alleged. The second component is 

whether the employment incident caused a personal injury and can be established only by 

medical evidence.6

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

condition and an employment incident is rationalized medical opinion evidence. 7 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 incident identified by the employee.8

ANALYSIS

The Board finds that appellant has not met her burden of proof to establish a diagnosed 

medical condition causally related to the accepted February 8, 2021 employment incident.

In support of her claim, appellant submitted a December 8, 2022 progress note signed by

Ms. Haas, a registered nurse, and Ms. Stanley, an advanced registered nurse practitioner.

However, certain healthcare providers such as nurses and nurse practitioners are not considered 

4 C.H., Docket No. 20-1212 (issued February 12, 2021); 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).

5 V.L., supra note 3; 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).

6 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). 

7 C.H., supra note 4; 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).

8 V.L., supra note 3; 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).
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physicians as defined under FECA.9 Consequently, their medical findings and/or opinions will 

not suffice for purposes of establishing entitlement to FECA benefits. 10

Appellant also submitted a December 5, 2022 x-ray and a December 8, 2022 MRI scan of 

her left shoulder. The Board has held, however, that diagnostic studies standing alone lack 

probative value on the issue of causal relationship as they do not provide an opinion on causal 

relationship between an employment incident and a diagnosed condition. 11

As appellant has not submitted rationalized medical evidence from a physician to 

establish a firm diagnosis of a medical condition causally related to the accepted February 8, 

2021 employment incident, the Board finds that she has not met her burden of proof. 12

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 causally related to the accepted February 8, 2021 employment incident.

9 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) (September 2020);N.F., Docket No. 21-1145(issued January 25, 2023) (nurses 

are not considered physicians as defined by FECA); B.L., Docket No. 22-1338 (issued January 20, 2023) (nurse 

practitioners are not considered physicians as defined by FECA); 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).

10 N.F., Docket No. 21-1145 (issued January 25, 2023); R.H., Docket No. 21-1382 (issued March 7, 2022);

S.E., Docket No. 21-0666 (issued December 28, 2021).

11 E.K., Docket 22-1130 (issued December 30, 2022); N.B., Docket No. 20-0794 (issued July 29, 2022); C.F., 

Docket No. 19-1748 (issued March 27, 2020);L.B., Docket No. 18-0533 (issued August 27, 2018); D.K., Docket 

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

12 N.F., supra note 10.; J.P., Docket No. 20-0381 (issued July 28, 2020); R.L., Docket No. 20-0284 (issued 

June 30, 2020).
5

ORDER

IT IS HEREBY ORDERED THAT the January 31, 2023 decision of the Office of

Workers’ Compensation Programs is affirmed.

Issued: July 27, 2023

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