United States Department of Labor

Employees’ Compensation Appeals Board

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L.W., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Phoenix, AZ, Employer

__________________________________________

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Docket No. 21-1325

Issued: May 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

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On September 1, 2021 appellant filed a timely appeal from an August 27, 2021 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 left ankle or foot 

condition causally related to the accepted November 5, 2020 employment incident.

1

5 U.S.C. § 8101 et seq.

2 The Board notes that, following the August27, 2021 decision, OWCP received additional evidence. However, 

the Board’s Rules of Procedures 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

FACTUAL HISTORY

On November 14, 2020 appellant, then a 56-year-old city delivery specialist, filed a 

traumatic injury claim (Form CA-1) alleging that on November 5, 2020 she twisted her left foot 

when she stepped out of her mail vehicle and sprained her ankle while in the performance of duty. 

On the reverse side of the claim form, appellant’s supervisor acknowledged that appellant was 

injured in the performance of duty. 

In a development letter dated November 18, 2020, OWCP informed appellant of the 

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

afforded appellant 30 days to submit the necessary evidence.

In response, appellantsubmitted a report dated November 6, 2020 from Debra S. Goulding, 

a family nurse practitioner. Ms. Goulding related that on November 5, 2020 appellant stepped out 

of her mail truck and twisted her left foot. She related that appellant’s left ankle and foot were

swollen and diagnosed left ankle and foot sprain. Ms. Goulding also completed a visit summary 

which provided work restrictions.

Appellant submitted an x-ray report dated November 6, 2020 from Dr. Elizabeth Orme 

Westfall, a Board-certified diagnostic radiologist. This report described an intact left ankle, left 

moderate hallux valgus with minimal 1st metatarsal head spurring, and left moderate plantar 

calcaneal spur.

Appellant submitted reports dated November 13, 18, and 24, and December 3 and 8, 2020 

from Candice Swanson, a physician assistant who diagnosed left foot and ankle sprain.

OWCP also received visit summaries from Ms. Swanson dated November 13 and 18, and 

December 3 and 8, 2020 which repeated appellant’s diagnoses and provided work restrictions.

By decision dated December 21, 2020, OWCP accepted that the November 5, 2020

employment incident occurred, as alleged, but denied appellant’s claim finding that she had not 

submitted medical evidence containing a medical diagnosis in connection with her accepted 

employment incident. It concluded, therefore, that the requirements had not been met to establish 

an injury as defined by FECA.

Appellant resubmitted the December 3 and 8, 2020 reports from Ms. Swanson, as well as 

the November 6, 2020 x-ray report.

OWCP received a claim for compensation (Form CA-7) for intermittent disability from 

work for the period November 6 through December 8, 2020.

On August 20, 2021 appellant requested reconsideration of OWCP’s December 21, 2020 

decision.

By decision dated August 27, 2021, OWCP denied modification of its December 21, 2020

decision.
3

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 period 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 must first be determined whether a fact of injury has been established. 

There are two components involved in establishing fact of injury. The first component to be 

established is that 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. 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 

nature of the relationship between the diagnosed condition and specific employment factors 

identified by the employee.9

ANALYSIS

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

foot condition causally related to the accepted November 5, 2020 employment incident. 

3

Id.

4 F.H., Docket No. 18-0869 (issued January 29, 2020); J.P., Docket No. 19-0129 (issued April26, 2019); Joe D. 

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 January 28, 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).
4

Appellant submitted an x-ray report dated November 6, 2020 from Dr. Elizabeth Orme 

Westfall which described findings of intact left ankle, left moderate hallux valgus with minimal 

1

st metatarsal head spurring, and left moderate plantar calcaneal spur The Board has held that 

diagnostic tests, standing alone, lack probative value on the issue of causal relationship as they do 

not address the relationship between the accepted employment factors and a diagnosed condition. 10 

For this reason, Dr. Westfall’s report is insufficient to meet appellant’s burden of proof.

OWCP also received a report dated November 6, 2020 from Ms. Goulding, a family nurse 

practitioner, as well as several reports and visit summaries from Ms. Swanson, a physician 

assistant, which noted diagnoses of left ankle and foot sprain. The Board has held that ccertain

healthcare providers such as physician assistants, nurse practitioners, and physical therapists are 

not considered physicians as defined under FECA.11 Their medical findings, reports and/or 

opinions, unless cosigned by a qualified physician, will not suffice for purposes of establishing 

entitlement to FECA benefits.12 Cconsequently, Ms. Goulding and Ms. Swanson’s documents will 

not suffice for purposes of establishing entitlement to FECA benefits.13

As the evidence of record is insufficient to establish that appellant has a diagnosed left 

ankle or foot condition causally related to the accepted November 5, 2020 employment incident, 

the Board finds that she 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 ankle or 

foot condition causally related to the November 5, 2020 employment incident. 

10 See W.M.,Docket No. 19-1853 (issued May 13, 2020); L.F.,Docket No. 19-1905 (issued April10, 2020).

11 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); see also M.F., Docket No. 19-1573 (issued March 16, 2020); N.B., 

Docket No. 19-0221 (issued July 15, 2019); 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).

12 S.E., Docket No. 21-0666 (issued December 28, 2021); K.A., Docket No. 18-0999 (issued October 4, 2019);

K.W., 59 ECAB 271, 279 (2007).

13 See M.C., Docket No. 19-1074 (issued June 12, 2020) (nurse practitioners are not considered physicians under 

FECA). 
5

ORDER

IT IS HEREBY ORDERED THAT the August 27, 2021 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: May 3, 2022

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board