United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

B.H., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Houston, TX, Employer

__________________________________________

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Docket No. 22-1004

Issued: November 3, 2022

Appearances: Case Submitted on the Record

Appellant, pro se,

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

PATRICIA H. FITZGERALD, Deputy Chief Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On June 22, 2022 appellant filed a timely appeal from a May 27, 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 her burden of proof to establish a right ankle 

condition causally related to the accepted June 10, 2021 employment incident.

1

5 U.S.C. § 8101 et seq.

2 The Board notes that, following the May27, 2022 decision, appellant submitted additional evidence to OWCP. 

However, 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.
2

FACTUAL HISTORY

On April 14, 2022 appellant, then a 33-year-old city carrier assistant, filed a traumatic 

injury claim (Form CA-1) alleging that on June 10, 2021 she lost her balance and fell on a rock as 

she was approaching a mailbox and fractured her right ankle while in the performance of duty.

She did not stop work.

A duty status report (Form CA-17) dated July 1, 2021 from an unidentifiable healthcare 

provider, diagnosed a right ankle sprain and provided work restrictions. Subsequent CA-17 forms

dated December 7, 2021 and March 8 and April 8, 2022 from the another unidentifiable healthcare 

provider, reiterated the prior diagnoses of a right ankle sprain and fracture and provided work 

restrictions.

An April 8, 2022 note from Dr. Travis Bodeker, a Board-certified podiatrist, noted that 

appellant was treated that date and was held off work until April 11, 2022. Dr. Bodeker advised 

that she was able to perform limited- to light-duty work due to a right ankle injury and that she 

required the use of a brace until further notice. In a Form CA-17 dated April 14, 2022, he released 

appellant to full-duty work, with restrictions.

In an April 26, 2020 development letter, OWCP advised appellant of the type of medical 

evidence necessary to establish her claim and attached a questionnaire for her completion. It 

afforded appellant 30 days to submit the requested evidence.

In response, appellant submitted a medical report dated April 25, 2022 from Dr. Richard 

Trifiro, Board-certified in family medicine, who noted that appellant presented with a right ankle 

injury. Appellant reported that the injury occurred on June 10, 2021, when she suddenly tripped 

over a rock while delivering mail. Dr. Trifiro recorded appellant’s description of needle-like pain 

and, upon examination, found swelling of the posterior Achilles insertion, radiating around 

anteriorly. He opined that her injury was the result of “twisting” while at work and diagnosed her 

with a right ankle sprain of an unspecified ligament.

In a work activity status report of even date signed by Dr. Trifiro, appellant was released 

to work on April 25, 2022 with updated restrictions of a maximum of four hours standing, eight 

hours sitting, and two hours walking, with mandated ankle splint support.

In an April 27, 2022 medical report, Dr. Trifiro conducted a physical examination which

revealed lateral swelling in the right ankle with tenderness in the Achilles tendon insertion, anterior 

talofibular ligament, calcaneofibular ligament, peroneal retinaculum and posterior talofibular 

ligament. Pain continued throughout the Achilles, radiating laterally around to the tibiofibular 

ligament, although medial pain had improved. Dr. Trifiro noted appellant’s right ankle sprain was 

in the beginning stages of healing. Appellant was directed to continue medication, apply heat

therapy, and follow a home exercise program. A work activity status report of even date provided 

unchanged work restrictions and directions to return for reevaluation in one week.

On April 29, 2022 the employing establishment offered, and appellant accepted,a modified 

limited-duty assignment as a modified city carrier position with work duties to include casing and 

delivering mail, and physical restrictions of walking intermittently up to two hours per day.
3

In a return-to-work note dated May 3, 2022, family nurse practitioner Brenda Thomas,

confirmed that appellant was seen that day and released her to work on May 4, 2022. In a Form 

CA-17 of even date, Ms. Thomas provided updated work restrictions including standing and 

kneeling for up to 30 minutes per day and no walking or climbing.

By decision dated May 27, 2022, OWCP accepted that the June 10, 2021 employment 

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

the medical evidence submitted was insufficient to establish causal relationship between her 

diagnosed condition and the accepted June 10, 2021 employment incident.

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 that the 

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

incident at the time and 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.7 

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 

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); 

DeloresC.Ellyett, 41 ECAB 992 (1990).

7 T.H., Docket No. 19-0599 (issued January28, 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).
4

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 not met her burden of proof to establish a right ankle

condition causally related to the accepted June 10, 2021 employment incident. 

In his April 25, 2022 reports, Dr. Trifiro related that she had sprained her right ankle on 

June 10, 2021 when she suddenly tripped over a rock while delivering mail at work. He diagnosed 

a moderate right ankle sprain and noted work restrictions. However, Dr. Trifiro did not provide 

an opinion on causal relationship. Likewise, in his April 27, 2022 follow-up note and work status 

report, he reiterated his work restrictions and noted that appellant’s ankle sprain was in the 

beginning stages of healing. Dr. Trifiro did not, however, address causation. The Board has held 

that medical reports lacking an opinion on causal relationship are of no probative value. 10 

Therefore, Dr. Trifiro’s April 25 and 27, 2022 reports are insufficient to establish appellant’s 

burden of proof. 

Similarly, in an April 8, 2022 note, Dr. Bodeker limited appellant to light-duty work and 

held her off work until April 11, 2022. He did not provide an opinion as to the cause of her 

condition or its relation to the accepted June 10, 2021 employment incident. As noted above, 

medical reports lacking an opinion on causal relationship are of no probative value. 11 Thus,

Dr. Bodeker’s report is also insufficient to establish appellant’s claim.

OWCP also received reports from Ms. Thomas, a family nurse practitioner. The Board has 

held that certain healthcare providers, such as nurses, are not considered “physicians” as defined 

under FECA.12 Consequently, their medical findings and/or opinions will not suffice for purposes 

of establishing entitlement to FECA benefits.

13

 This evidence, therefore, is of no probative value. 

The remaining evidence of record consists of illegible reports and those from an unknown 

healthcare provider. The Board has held that reports that are unsigned or bear an illegible signature 

9 A.S., Docket No. 19-1955 (issued April9, 2020);LeslieC. Moore, 52 ECAB 132 (2000).

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

11 Id.

12 See B.R., Docket No. 21-1109 (issued December 28, 2021); J.K., Docket No. 20-0591 (issued August12, 2020); 

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

13 See 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); 5 U.S.C. § 8101(2) (this subsection 

defines a physician as surgeons, podiatrists, dentists, clinical psychologists, optometrists, chiropractors, and 

osteopathic practitioners within the scope of their practice as defined by state law).
5

cannot be considered probative medical evidence as the author cannot be identified as a 

physician.14 Thus, these reports have no probative value and are insufficient to establish the claim. 

As appellant has not submitted rationalized medical evidence sufficient to establish causal

relationship between her diagnosed right ankle condition and the accepted June 10, 2021

employment incident, the Board finds that she has not met her burden of proof to establish her

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 her burden of proof to establish a right ankle 

condition causally related to the accepted June 10, 2021 employment incident.

ORDER

IT IS HEREBY ORDERED THAT the May 27, 2022 decision of the Office of Workers’

Compensation Programs is affirmed. 

Issued: November 3, 2022

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board

14 See T.P., Docket No. 21-0868 (issued December 21, 2021); R.L., Docket No. 20-0284 (issued June30, 2020); 

M.A., Docket No. 19-1551 (issued April30, 2020); T.O., Docket No. 19-1291 (issued December 11, 2019); MertonJ. 

Sills, 39 ECAB 572, 575 (1988).