United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

J.G., Appellant

and

DEPARTMENT OF VETERANS AFFAIRS, 

BIRMINGHAM VA MEDICAL CENTER, 

Birmingham, AL, Employer

__________________________________________

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Docket No. 23-0324

Issued: January 9, 2024

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

PATRICIA H. FITZGERALD, Deputy Chief Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On January 3, 2023 appellant filed a timely appeal from September 12 and November 9, 

2022 merit decisions 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 his burden of proof to establish Bell’s Palsy causally 

related to the accepted July 21, 2022 employment incident.

1

5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY

On July 31, 2022 appellant, then a 60-year-old police officer, filed a traumatic injury claim 

(Form CA-1) alleging that on July 21, 2022 he sustained Bell’s Palsy due to stress after another 

police officer confronted him while in the performance of duty. He stopped work on July 22, 2022. 

In a work status note dated August 1, 2022, Alicia Beck, a nurse practitioner, excused 

appellant from work through August 8, 2022, and noted that he could return to work on 

August 9, 2022. 

In a letter dated August 2, 2022, A.D., a workers’ compensation program specialist for the 

employing establishment, controverted appellant’s claim. She indicated that appellant had not 

submitted witness statements or medical reports containing a medical diagnosis that was causally 

related to the alleged work incident.

In an August 3, 2022 development letter, OWCP informed appellant of the deficiencies of 

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

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

respond.

In a hospital patient summary report dated July 23, 2022, Dr. Scott Pfitzer, an emergency 

medicine specialist, recounted appellant’s complaints of left eye pain and numbness to the left side 

of the face that started yesterday around 8:30 p.m. He reviewed appellant’s diagnostic test results 

and diagnosed eye pain, left facial numbness, and Bell’s Palsy. A hospital discharge instruction

sheet also noted a diagnosis of Bell’s Palsy.

Appellant underwent diagnostic testing results on July 23, 2022. A magnetic resonance 

imaging (MRI) scan of the brain/head showed no significant brain or head abnormality. A 

computerized tomography (CT) scan of the head demonstrated no acute intracranial abnormality. 

OWCP received after visit summary reports dated July 26 and August 1, 2022, wherein

Dr. Pfitzer indicated that appellant was treated for right hand pain and facial paralysis/Bell’s Palsy. 

By decision dated September 12, 2022, OWCP accepted that the July 21, 2022 

employment incident occurred as alleged, but denied the claim, finding that the medical evidence 

of record was insufficient to establish causal relationship between appellant’s diagnosed condition 

and the accepted July 21, 2022 employment incident.

Appellant subsequently submitted an August 11, 2022 report by Dr. Amit Arora, a 

neurologist, who indicated that on July 22, 2022 appellant experienced an abrupt onset of left facial 

drop. He had informed Dr. Arora that he had a confrontation with a coworker the previous day,

and he thoughtthat he may have experienced some mild left facial droop at night. Appellant noted 

that the following day, his wife noticed a significant facial droop and his inability to close his left 

eye. He reported that he went to the emergency room where diagnostic reports showed no acute 

abnormalities. On physical examination, Dr. Arora observed decreased facial sensation and 

weaknesses. He reported that he had concerns of cranial VII nerve palsy, likely secondary to Bell’s 

Palsy. Dr. Arora recommended further evaluation.
3

OWCP also received additional diagnostic test reports. An August 24, 2022 brain and 

internal auditory canals MRI scan showed enhancement of portions of the left facial nerve and 

some fluid signal in the right petrous air cells.

A September 20, 2022 CT scan of the temporal bones revealed asymmetric pneumatization 

of the right petrous apex with associated nonexpansile fluid opacification, consistent with trapped 

fluid within the pneumatized air cells. 

On November 4, 2022 appellant requested reconsideration. He alleged that his neurologist,

Dr. Arora, informed him that the incident at work was the cause of his injury. 

Appellant submitted a head magnetic resonance angiograph (MRA) report dated July 23, 

2022, which demonstrated no significant abnormality. 

By decision dated November 9, 2022, OWCP denied modification of its September 12, 

2022 decision.

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 

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, OWCP must first determine whether fact of injury has been established. 6 

There are two components involved in establishing fact of injury. First, the employee must submit 

sufficient evidence to establish that he or she actually experienced the employment incident at the 

time and place, and in the manner alleged. Second, the employee must submit probative medical 

evidence to establish that the employment incident caused an injury.7 

2

Id. 

3 F.H., Docket No. 18-0869 (issued January 29, 2020); S.B., Docket No. 17-1779 (issued February 7, 2018); JoeD. 

Cameron, 41 ECAB 153 (1989). 

4 L.C., Docket No. 19-1301 (issued January 29, 2020); J.M., Docket No. 17-0284 (issued February 7, 2018); 

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

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

L.M., Docket No. 13-1402 (issued February 7, 2014); Delores C. Ellyett, 41 ECAB 992 (1990).

6 D.B., Docket No. 18-1348 (issued January 4, 2019); S.P., 59 ECAB 184 (2007).

7 T.H., Docket No. 19-0599 (issued January 28, 2020); B.M., Docket No. 17-0796 (issued July 5, 2018); David 

Apgar, 57 ECAB 137 (2005); John J. Carlone, 41 ECAB 354 (1989).
4

To establish causal relationship between the condition, as well as any attendant disability 

claimed and the employment event or incident, the employee must submit 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 employee. 9 

ANALYSIS

The Board finds that appellant has not met his burden of proof to establish Bell’s Palsy 

causally related to the accepted July 21, 2022 employment incident.

Appellant submitted an August 11, 2022 report, wherein Dr. Arora related that appellant 

had a confrontation with a coworker and experienced facial droop and inability to close his left 

eye the following day. Dr. Arora provided examination findings and reported that he had concerns 

of cranial VII nerve palsy, likely secondary to Bell’s Palsy. He, however, did not provide an 

opinion on the cause of appellant’s diagnosed conditions. 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 on the issue of causal relationship.10 Therefore, this report is insufficient to 

establish appellant’s burden of proof.

Likewise, the hospital emergency room reports by Dr. Pfitzer are also insufficient to 

establish appellant’s claim as they do not offer an opinion on causal relationship. As explained 

above, 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 on the issue of causal relationship.11 Therefore, 

these reports are insufficient to establish appellant’s burden of proof. 

Appellant also submitted an August 1, 2022 work status note from a nurse practitioner. 

The Board has held that certain healthcare providers such as nurse practitioners are not considered 

8

S.S., Docket No. 19-0688 (issued January 24, 2020); S.A., Docket No. 18-0399 (issued October 16, 2018); see 

also Robert G. Morris, 48 ECAB 238 (1996).

9 C.F., Docket No. 18-0791 (issued February 26, 2019); M.V., Docket No. 18-0884 (issued December 28, 2018); 

I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 ECAB 345 (1989).

10 R.O., Docket No. 20-1243 (issued May 28, 2021); L.B., Docket No. 18-0533 (issued August27, 2018); D.K., 

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

11 Id.; see also K.R., Docket No. 21-0822 (issued June 28, 2022); M.G., Docket No. 19-1863 (issued 

December 15, 2020.
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physicians as defined under FECA.12 Consequently, their medical findings and/or opinions will 

not suffice for purposes of establishing entitlement to FECA benefits. 

The remaining evidence of record consists of diagnostic testing reports dated July 23, 

August 24, and September 20, 2022. The Board has held that reports of diagnostic tests, standing 

alone, lack probative value as they do not provide an opinion as to whether the accepted 

employment factors caused the diagnosed condition. For this reason, this evidence is not sufficient 

to meet his burden of proof.13 

As the medical evidence of record is insufficient to establish Bell’s Palsy causally related 

to the accepted July 21, 2022 employment incident, the Board finds that appellant 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 not met his burden of proof to establish Bell’s Palsy 

causally related to the accepted July 21, 2022 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 alsoB.D.,Docket No. 22-0503 (issued September 27, 2022 (nurse practitioners are not considered 

physicians as defined under FECA and their medical findings and/or opinions will not suffice for purposes of 

establishing entitlement to FECA benefits); L.S., Docket No. 19-1231 (issued March 30, 2021) (nurse practitioners

are not considered physicians as defined under FECA).

13 V.Y., Docket No. 18-0610 (issued March 6, 2020); G.S., Docket No. 18-1696 (issued March 26, 2019); A.B., 

Docket No. 17-0301 (issued May 19, 2017).
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ORDER

IT IS HEREBY ORDERED THAT the September 12 and November 9, 2022 decisions 

of the Office of Workers’ Compensation Programs are affirmed.

Issued: January 9, 2024

Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board