United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

A.P., Appellant

and

DEPARTMENT OF VETERAN AFFAIRS, 

CORPORAL MICHAEL J. CRESCENZ VA 

MEDICAL CENTER, Philadelphia, PA,

Employer

__________________________________________

)

)

)

)

)

)

)

)

)

)

Docket No. 22-1084

Issued: March 8, 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

VALERIE D. EVANS-HARRELL, Alternate Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On July 11, 2022 appellant filed a timely appeal from a May 6, 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

1

5 U.S.C. § 8101 et seq.

2 The Board notes that, following the May 6, 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

ISSUE

The issue is whether appellant has met her burden of proof to establish a diagnosed medical 

condition in connection with the accepted March 17, 2022 employment incident.

FACTUAL HISTORY

On March 28, 2022 appellant, then a 33-year-old medical technician, filed a traumatic 

injury claim (Form CA-1) alleging that on March 17, 2022 she sustained a head, neck, and back 

injury when another vehicle rear ended her vehicle as she attempted to exit the employing 

establishment parking lot while in the performance of duty. She explained that immediately 

following the incident she began experiencing a warming and burning sensation in her lower back,

she had difficulty standing, and developed an unbearable headache. Appellant stopped work on 

the date of the alleged incident. 

In support of her claim, appellant submitted a March 17, 2022 return to work note from 

Patrick Phelan, a physician assistant, excusing her from work for two days. 

In a letter dated March 22, 2022, Lauren Thomas, a patient care coordinator, confirmed

that appellant had been seen in the office on that day, and requested that appellant be excused for 

her appointment. 

In a March 29, 2022 letter, the employing establishment controverted appellant’s claim, 

contending that the accident happened after her work shift ended, and therefore, she was not in the 

performance of duty when injured. It did not dispute that the incident occurred on March 17, 2022 

as alleged and that she was injured. 

In an April 6, 2022 development letter, OWCP informed appellant of the deficiencies of 

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

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

submit the necessary evidence. 

Thereafter, OWCP received a March 17, 2022 return to work note from Mr. Phelan, 

excusing appellant from work through March 22, 2022. An office visit summary dated March 30, 

2022 confirmed that appellant was seen that day by Eric Bartholomew, a nurse practitioner, and 

noted diagnoses of an autoimmune disease, asthma, low vitamin D, and lower back and neck pain. 

He ordered diagnostic studies of her thoracic spine due to lower back pain. 

April 1, 2022 diagnostic reports of appellant’s thoracic and lumbar spine completed by

Dr. Antoni Parellada, a Board-certified diagnostic radiologist, demonstrated moderate 

degenerative disc disease with height loss and marginal osteophytes in the thoracic spine and no 

abnormalities of the lumbar spine. 

In an April 6, 2022 letter, Chandani Borad, a physical therapist, requested 45 days of

medical leave for appellant so that she may recover from cervical and lumbar pain with 

accompanying headaches. 
3

In an April 12, 2022 letter, the employing establishment controverted appellant’s claim for 

continuation of pay contending that the medical reports submitted were not signed by a qualified 

physician as defined by 5 U.S.C. § 8101(2). 

An undated return to work note from Mr. Bartholomew, confirmed that appellant was 

under his care for changes to her thoracic spine related to an accident, and noted that she would 

need to see a physical therapist and spinal surgeon. He held her off work until June 13, 2022. 

In an April 20, 2022 response to OWCP’s questionnaire, appellant reiterated thatshe was 

rear ended by a vehicle near the front entry of the employing establishment.

By decision dated May 6, 2022, OWCP accepted that the March 17, 2022 employment 

incident occurred, as alleged and that appellant was in the performance of duty when the 

employment incident occurred. However, it denied her traumatic injury claim, finding that she 

had not submitted any medical evidence containing a medical diagnosis in connection with the 

accepted employment incident. Consequently, OWCP found that appellant had not met the 

requirements to establish an injury as defined by FECA.

LEGAL PRECEDENT

An employee seeking benefits under FECA has the burden of proof to establish the 

essential elements of his or her claim, including that 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.3 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.4

To determine if an employee has sustained a traumatic injury in the performance of duty, 

OWCP begins with an analysis of whether fact of injury has been established. Fact of injury

consists of two components that must be considered in conjunction with one another. The first 

component is whether the employee actually experienced the employment incident that allegedly 

occurred at the time, place, and in the manner alleged.

5

 The second component is whether the 

employment incident caused a personal injury.6

Rationalized medical opinion evidence is required to establish causal relationship. The 

opinion of the physician must be based on a complete factual and medical background, must be 

one of reasonable medical certainty, and must be supported by medical rationale explaining the 

3

J.M., Docket No. 17-0284 (issued February 7, 2018); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40 

ECAB 312 (1988).

4 K.M., Docket No. 15-1660 (issued September 16, 2016); L.M., Docket No. 13-1402 (issued February 7, 2014); 

DeloresC. Ellyett, 41 ECAB 992 (1990).

5 B.P., Docket No. 16-1549 (issued January 18, 2017);Elaine Pendleton, 40 ECAB 1143 (1989).

6 M.H., Docket No. 18-1737 (issued March 13, 2019); John J. Carlone, 41 ECAB 354 (1989).
4

nature of the relationship between the diagnosed condition and the specific employment incident.7 

Neither the mere fact that a disease or condition manifests itself during a period of employment, 

nor the belief that the disease or condition was caused or aggravated by employment factors or 

incidents is sufficient to establish causal relationship.

8

ANALYSIS

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

medical condition in connection with the accepted March 17, 2022 employment incident. 

Appellant submitted April 1, 2022 diagnostic studies which revealed degenerative disc 

disease with height loss and marginal osteophytes in the thoracic spine and no abnormalities of the 

lumbar spine. The Board has explained, however, that diagnostic studies, standing alone, lack 

probative value as they do not address whether the employment incident caused any of the 

diagnosed conditions.9 Thus, these reports are also insufficient to establish appellant’s claim. 

The remaining medical evidence of record consists of notes from Mr. Bartholomew, a 

nurse practitioner; Mr. Phelan, a physician assistant; and Ms. Borad, a physical therapist. The 

Board has held that medical reports signed solely by physician assistants, nurse practitioners, and 

physical therapists are of no probative value as such healthcare providers are not considered 

physicians as defined by FECA and therefore, are not competent to provide a medical opinion. 

Consequently, their medical findings and/or opinions will not suffice for purposes of establishing 

entitlement to FECA benefits.

10

As a result, there is no medical evidence of record sufficient to establish a diagnosed 

medical condition in connection with the accepted March 17, 2022 employment incident. The 

Board finds, therefore, 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 10.607.15.

7

S.S., Docket No. 18-1488 (issued March 11, 2019).

8

J.L., Docket No. 18-1804 (issued April12, 2019).

9 M.B., Docket No. 19-1638 (issued July 17, 2020); T.S., Docket No. 18-0150 (issued April12, 2019).

10 Section 8101(2) of FECA 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 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 A.M., Docket No. 20-1575 (issued May 24, 2021) (physical therapists are not physicians as defined 

by FECA); A.C., Docket No. 20-1510 (issued April23, 2021) (physician assistants are not physicians as defined by 

FECA); C.A., Docket No. 18-0824 (issued November 15, 2018)(nurse practitioners are not considered physicians as 

defined by FECA).
5

CONCLUSION

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

medical condition in connection with the accepted March 17, 2022 employment incident. 

ORDER

IT IS HEREBY ORDERED THAT the May 6, 2022 decision of the Office of Workers’

Compensation Programs is affirmed. 

Issued: March 8, 2023

Washington, DC

Alec J. Koromilas, 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