United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

F.N., Appellant

and

U.S. POSTAL SERVICE, SOUTHSIDE ANNEX,

Lebanon, TN, Employer

__________________________________________

)

)

)

)

)

)

)

)

Docket No. 23-0071

Issued: April 7, 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 October 20, 2022 appellant filed a timely appeal from an October 18, 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 his burden of proof to establish a medical condition

causally related to the accepted June 28, 2022 employment incident.

1 5 U.S.C. § 8101 et seq.

2 The Board notes that, following the October 18, 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

FACTUAL HISTORY

On August 24, 2022 appellant, then a 55-year-old rural carrier, filed a traumatic injury 

claim (Form CA-1) alleging that on June 28, 2022 he developed a bulging disc in his back and a 

pinched nerve in his left shoulder when he was rearended by another vehicle while in the 

performance of duty. He stopped work on June 28, 2022 and returned to work on July 7, 2022.

Appellant submitted reports of diagnostic testing performed on June 28, 2022. A

computerized tomography (CT) scan report of his cervical spine noted an impression of moderately 

severe degenerative right foraminal narrowing at C4-5, moderate C4-5 left foraminal narrowing, 

moderate C3-4 right foraminal narrowing, and mild degenerative narrowing of the spinal canal in 

anteroposterior diameter at C4-5. A CT scan report of the lumbar spine noted an impression of 

L4-5 disc height loss, broad-based posterior disc bulge measuring at least 3 millimeters (mm), 

facet arthrosis, mild central canal and mild-to-moderate bilateral foraminal narrowing, L5-S1 disc 

height loss, broad-based posterior disc osteophyte complex measuring 4 mm, right greater than 

left facet arthrosis with hypertrophy, and moderate right foraminal, mild central canal and mild 

left foraminal narrowing. A CT scan report of the thoracic spine noted an impression of no acute 

traumatic findings. 

In a June 30, 2022 return to work note, an unidentified healthcare provider held appellant

off work until July 6, 2022. 

On August 31, 2022 the employing establishment executed an authorization for 

examination and/or treatment (Form CA-16). In Part B of the Form CA-16, attending physician’s 

report, a physician whose signature is illegible related that appellant injured his left shoulder in a 

motor vehicle accident and diagnosed cervical radiculopathy. The unidentified physician checked 

a box marked “Yes” to indicate that the condition was caused or aggravated by the employment 

activity described and returned appellant to regular duty on July 7, 2022.

In a September 15, 2022 development letter, OWCP informed appellant of the deficiencies 

of his claim. It advised him of the additional factual and medical evidence needed to establish his 

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

respond.

Thereafter, OWCP received a June 29, 2022 accident report noting that on June 28, 2022

appellant was rearended due to the inattentiveness of the driver. 

Appellant also submitted an August 17, 2022 patient chart and an August 31, 2022 

summary report from unidentified healthcare providers. 

In a September 19, 2022 statement, appellant recounted that on June 28, 2022 at about 

10:15 a.m. he was stopped at a mailbox when he was rearended by a woman who was not paying 

attention. 

By decision dated October 18, 2022, OWCP accepted that the June 28, 2022 employment 

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

the evidence of record was insufficient to establish causal relationship between his diagnosed 

medical condition and the accepted June 28, 2022 employment incident. 
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 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 whether he or 

she actually experienced the employment incident at the time, 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 the specific employment incident 

identified by the claimant.9

ANALYSIS

The Board finds that appellant has not met his burden of proof to establish a medical 

condition causally related to the accepted June 28, 2022 employment incident.

Appellant submitted an August 31, 2022 Form CA-16 including Part B, attending 

physician’s report, from a physician whose signature is illegible diagnosing cervical radiculopathy 

3 Supra note 1.

4 F.H., Docket No.18-0869 (issued January 29, 2020); J.P., Docket No. 19-0129 (issued April 26, 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); 

Delores C. 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 April 24, 2019); Robert G. 

Morris, 48 ECAB 238 (1996).

9 A.S., Docket No. 19-1955 (issued April 9, 2020); Leslie C. Moore, 52 ECAB 132 (2000).
4

and relating that appellant injured his left shoulder. The healthcare provider checked a box marked 

“Yes” to indicate that the condition was caused or aggravated by the described employment 

activity and returned appellant to regular duty on July 7, 2022. The Board has held that reports 

that are unsigned or bear an illegible signature lack proper identification and cannot be considered 

probative medical evidence as the author cannot be identified as a physician.10 Therefore, this 

evidence is insufficient to establish appellant’s claim. 

Similarly, appellant submitted a June 30, 2022 return to work note, August 17, 2022 patient

chart, and August 31, 2022 summary report from unidentified healthcare providers. As these 

reports lack proper signatures identifying the author as a physician, they cannot be considered 

probative medical evidence and are insufficient to establish his claim.11

The remaining evidence of record includes June 28, 2022 CT scan reports of appellant’s 

cervical, lumbar, and thoracic spine. The Board has held that diagnostic reports, standing alone, 

lack probative value on the issue of causal relationship as they do not provide an opinion as to 

whether the accepted employment incident caused a diagnosed condition.12 For this reason, this 

evidence is also insufficient to establish appellant’s claim.

As appellant has not submitted rationalized medical opinion evidence establishing a 

medical condition causally related to the accepted June 28, 2022 employment incident, the Board 

finds that he 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 10.607.13

CONCLUSION

The Board finds that appellant has not met his burden of proof to establish a medical 

condition causally related to the accepted June 28, 2022 employment incident.

10 L.B., Docket No. 21-0353 (issued May 23, 2022); T.D., Docket No. 20-0835 (issued February 2, 2021); Merton J. 

Sills, 39 ECAB 572, 575 (1988).

11 Id.

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

13 The Board notes that the employing establishment issued a Form CA-16, dated August 31, 2022. A completed 

Form CA-16 authorization may constitute a contract for payment of medical expenses to a medical facility or 

physician, when properly executed. The form creates a contractual obligation, which does not involve the employee 

directly, to pay for the cost of the examination or treatment regardless of the action taken on the claim. See 20 C.F.R. 

§ 10.300(c); V.S., Docket No. 20-1034 (issued November 25, 2020); J.G., Docket No. 17-1062 (issued February 13, 

2018); Tracy P. Spillane, 54 ECAB 608 (2003).
5

ORDER

IT IS HEREBY ORDERED THAT the October 18, 2022 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: April 7, 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