United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

A.T., Appellant

and

U.S. POSTAL SERVICE, PHILADELPHIA 

PROCESSING & DISTRIBUTION CENTER, 

Philadelphia, PA, Employer

__________________________________________

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Docket No. 23-0512

Issued: October 17, 2023

Appearances: Case Submitted on the Record

Michael D. Overman, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

PATRICIA H. FITZGERALD, Deputy Chief Judge

JANICE B. ASKIN, Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On March 1, 2023 appellant, through counsel, filed a timely appeal from a September 7, 

2022 merit decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to the 

Federal Employees’ Compensation Act2(FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board 

has jurisdiction over the merits of this case.

1

In all cases in which a representative has been authorized in a matter before the Board, no claim for a fee for legal 

or other service performed on appeal before the Board is valid unless approved by the Board. 20 C.F.R. § 501.9(e). 

No contract for a stipulated fee or on a contingent fee basis will be approved by the Board. Id. An attorney or 

representative’s collection of a fee without the Board’s approval may constitute a misdemeanor, subject to fine or 

imprisonment for up to one year or both. Id.; see also 18 U.S.C. § 292. Demands for payment of fees to a 

representative, prior to approval by the Board, may be reported to appropriate authorities for investigation.

2

5 U.S.C. § 8101 et seq.
2

ISSUE

The issue is whether appellant has met her burden of proof to establish a left shoulder 

condition causally related to the accepted September 10, 2020 employment incident.

FACTUAL HISTORY

On November 18, 2020 appellant, then a 61-year-old postal distribution clerk, filed a 

traumatic injury claim (Form CA-1) alleging that on September 10, 2020 she sustained a left 

shoulder injury when lifting mail trays while in the performance of duty. She stopped work on 

November 6, 2020.

In a development letter dated November 20, 2020, OWCP informed appellant of the 

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

afforded her 30 days to submit the requested evidence.

In support of her claim, appellant submitted an October 5, 2020 note from Dr. David L. 

Glaser, a Board-certified orthopedist, who treated her for left shoulder pain over the lateral aspect 

of the arm. She reported difficulty in reaching, lifting, pulling, and overhead activities. Findings 

on physical examination revealed pain through the impingement zones, positive Jobe’s maneuver, 

and pain with abdominal compression maneuver. Dr. Glaser noted that x-rays of the left shoulder 

revealed a large enthesophyte with tuberosity changes consistent with a rotator cuff tear. He 

diagnosed rotator cuff disease of the left shoulder and recommended physical therapy. In a return 

to work note of even date, Dr. Glaser advised that appellant was totally disabled from work.

An October 19, 2020 magnetic resonance imaging (MRI) scan of the left shoulder revealed 

partial-thickness undersurface tearing of the supraspinatus tendon extending to the junction with 

the anterior infraspinatus tendon with delaminating component and tendinosis, high grade near 

full-thickness to full-thickness tearing of the superior subscapularis tendon, severe proximal long 

head biceps tendinosis with medial subluxation into the substance of the subscapularis, 

subacromial spur, mild acromioclavicular (AC) osteoarthritis, and glenohumeral degenerative 

changes.

On November 2, 2020 Dr. Glaser noted that appellant was totally disabled from work. On 

November 17, 2020 he performed arthroscopic left shoulder rotator cuff repair, arthroscopic biceps 

tenodesis, and arthroscopic acromioplasty, and diagnosed left shoulder complete tendon tear with 

impingement, glenohumeral joint arthritis, and biceps tenosynovitis with tearing. The procedure 

was not authorized by OWCP. 

In a statement dated November 3, 2020, appellant indicated that on September 10, 2020 

she volunteered to clear a line of standard mail because her unit was short staffed, and asserted 

that she was required to lift more trays than usual on that date. She noted that she filled three bulk 

mail containers and felt a pulling sensation in her left shoulder. Appellant felt discomfort that 

evening and sought medical treatment.

In a letter dated December 4, 2020, Mathew Maust, a physician assistant, opined that 

appellant’s shoulder injury was work related.
3

Appellant provided a response to the development letter on December 15, 2020 in which 

she noted that after the September 10, 2020 injury she experienced a pulling sensation in her left 

shoulder. She advised that her pain subsided after treatment with oral analgesics, but it returned a 

couple of days later. Appellant reported a history of left shoulder symptoms for one year. 

By decision dated December 30, 2020, OWCP denied appellant’s traumatic injury claim, 

finding that the medical evidence submitted was insufficient to establish causal relationship 

between her diagnosed conditions and the accepted September 10, 2020 employment incident. It 

concluded, therefore, that the requirements had not been met to establish an injury or condition 

due to the accepted employment factors.

On January 14, 2021 appellant requested reconsideration. 

OWCP received additional evidence. In a January 11, 2021 report, Dr. Glaser opined 

within a reasonable degree of medical certainty that appellant’s “left rotator cuff tear was either 

caused by or significantly aggravated by [appellant’s] work activities” and that the provided 

treatment was reasonable and necessary. In a letter dated February 22, 2021, Mr. Maust noted that 

appellant was under the care of Dr. Glaser and could not return to work until after her next 

appointment in six weeks.

By decision dated March 5, 2021, OWCP denied modification of the December 30, 2020

decision.

OWCP received additional evidence. An x-ray of the left shoulder dated October 5, 2020

revealed mild degenerative changes of the AC joint with subacromial spurring. 

In a letter dated April 5, 2021, Mr. Maust noted that appellant could not return to work 

until after her next appointment in six weeks.

Dr. Glaser treated appellant on September 14, 2021 and diagnosed status-post left rotator 

cuff repair and partial nontraumatic tear of the right rotator cuff. In a narrative report dated 

September 14, 2021, he noted that her history was significant for right shoulder pain that began in 

2002 and required right rotator cuff repair in 2009. Appellant presented in October 2020 with left 

shoulder pain and explained that she continued to have right shoulder pain , which resulted in 

increasing use of her left shoulder. An MRI scan of the left shoulder revealed a subluxed long 

head of the biceps tendon, degenerative and torn subscapularis, and a partial tear of the 

supraspinatus. On November 17, 2020 appellant underwent left shoulder surgery. Dr. Glaser 

opined within a reasonable degree of medical certainty that appellant’s left shoulder rotator cuff 

abnormalities and the need for treatment were directly related to her work at the employing 

establishment. He indicated that, if it were not for her work as a mail handler, she would not have 

required treatment for her bilateral shoulders. Dr. Glaser opined that the right shoulder rotator cuff 

deficiency led to increased use of appellant’s left shoulder to complete her work tasks. He 

indicated that her job required performing activities that involved reaching and lifting with the left 

shoulder, which led to the development of symptoms related to her shoulder. Dr. Glaser explained 

that the rotator cuff was exposed to increased stress when the arm was placed away from the body 

such as required for a mail handler. 

On March 7, 2022 appellant, through counsel, requested reconsideration. 
4

Dr. Glaser continued to treat appellant through May 16, 2022 for left shoulder pain. He 

diagnosed rotator cuff tear of the left shoulder status postsurgery and continued work restrictions.

Dr. Glaser noted without elaboration, “[m]y opinion is [sic] stated on the previous report remain 

[sic] unchanged.” 

By decision dated September 7, 2022, OWCP denied modification of the March 5, 2021

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. First, 

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. Second, the employee must 

submit sufficient evidence to establish that the employment incident caused a personal injury. 7

The medical evidence required to establish a causal relationship 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 

specific employment incident identified by the employee. 9

3

Id.

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.J., Docket No. 19-0461 (issued August 11, 2020); K.L., Docket No. 18-1029 (issued January 9, 2019); John J. 

Carlone, 41 ECAB 354 (1989).

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 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).
5

ANALYSIS

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

condition causally related to the accepted September 10, 2020 employment incident.

Appellant submitted an October 5, 2020 report from Dr. Glaser who diagnosed rotator cuff 

disease of the left shoulder and took her off work. In a return to work note of even date, Dr. Glaser 

advised that she was totally disabled from work. Similarly, on November 2, 2020 he indicated 

that appellant could not return to work until further notice. On November 17, 2020 Dr. Glaser 

performed arthroscopic left shoulder rotator cuff repair and diagnosed left shoulder complete 

tendon tear with impingement, glenohumeral joint arthritis, and biceps tenosynovitis with tearing. 

He treated appellant on September 14, 2021 and diagnosed status-post left rotator cuff repair and 

partial nontraumatic tear of the right rotator cuff. In a May 16, 2022 report, Dr. Glaser diagnosed 

rotator cuff tear of the left shoulder status postsurgery and continued work restrictions. He noted 

without elaboration, “[m]y opinion is [sic] stated on the previous report remain [sic] unchanged.” 

However, these reports failed to provide an opinion regarding the cause of appellant’s left shoulder 

condition.10 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.11 These reports are thus insufficient 

to establish causal relationship.

On January 11, 2021 Dr. Glaser opined within a reasonable degree of medical certainty 

that appellant’s left rotator cuff tear was either caused by or significantly aggravated by her work 

activities. In a narrative report dated September 14, 2021, he opined within a reasonable degree 

of medical certainty that her left shoulder rotator cuff abnormalities and the need for treatment 

were directly related to her work at the employing establishment. Dr. Glaser maintained that if it 

were not for appellant’s work as a mail handler she would not have required treatment for her 

bilateral shoulders. He indicated that appellant’s job required performing activities that involved 

reaching and lifting with the left shoulder, which led to the development of shoulder symptoms.

While Dr. Glaser indicated that her left shoulder injury was work related, he failed to provide 

adequate medical rationale explaining the basis of his opinion. Without explaining, 

physiologically, how the specific employment incident or employment factors caused or 

aggravated the diagnosed condition, his opinions on causal relationship are of limited probative 

value and insufficient to establish appellant’s claim.12 

Appellant submitted reports from a physician assistant. However, certain healthcare 

providers such as physician assistants13 are not considered “physician[s]” as defined under 

10 L.D., Docket No. 18-1468 (issued February 11, 2019).

11 See L.B., Docket No. 18-0533 (issued August 27, 2018); D.K., Docket No. 17-1549 (issued July 6, 2018).

12 G.L., Docket No. 18-1057 (issued April14, 2020); J.P., 59 ECAB 178 (2007); Joe D. Cameron, supra note 4.

13 See S.E., Docket No. 08-2214 (issued May 6, 2009) (reports of a physician assistant have no probative value as 

medical evidence).
6

FECA.14 Consequently, their medical findings and/or opinions will not suffice for purposes of 

establishing entitlement to FECA benefits.

15

 

Appellant also submitted an MRI scan and x-rays. The Board has held that diagnostic 

studies, standing alone, lack probative value on the issue of causal relationship as they do not 

provide an opinion as to whether the employment incident caused any of the diagnosed 

conditions.16 This evidence is, therefore, insufficient to establish appellant’s claim.

As the medical evidence of record is insufficient to establish a medical condition causally 

related to the accepted September 10, 2020 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 left shoulder

condition causally related to the accepted September 10, 2020 employment incident. 

14 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); 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); George H. Clark, 56 ECAB 

162 (2004) (physician assistants are not considered physicians under FECA).

15 Id.

16 C.B., Docket No. 20-0464 (issued July 21, 2020).
7

ORDER

IT IS HEREBY ORDERED THAT the September 7, 2022 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: October 17, 2023

Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board