United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

A.S., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE,

Bedford Park, IL, Employer

__________________________________________

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Docket No. 21-1263

Issued: July 24, 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

PATRICIA H. FITZGERALD, Deputy Chief Judge

JANICE B. ASKIN, Judge

JURISDICTION

On August 19, 2021 appellant filed a timely appeal from May 25, June 3, and August 18, 

2021 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.

ISSUES

The issues are: (1) whether appellant has met his burden of proof to establish disability 

from work commencing April 6, 2021, causally related to his accepted February 1, 2021

employment injury; and (2) whether he has met his burden of proof to expand the acceptance of 

his claim to include additional conditions as causally related to the accepted February 1, 2021 

employment injury.

1

5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY

On February 5, 2021 appellant, then a 43-year-old human resource clerk, filed a traumatic 

injury claim (Form CA-1) alleging that he injured the bottom of his right foot on February 1, 2021 

when he slipped on ice while in the performance duty. He stopped work on February 2, 2021 and 

returned to modified-duty work for six hours a day on February 3, 2021.

In a medical report dated February 1, 2021, Dr. Maria Vlahos, an occupational medicine 

specialist, indicated that appellant complained of pain in the right foot which he attributed to 

slipping on ice.2 On examination,she observed mild swelling in the arch along the sole, tenderness 

in the medial midfoot, and mild limitation in flexion and extension of all of the toes at the 

metatarsophalangeal (MTP) joints. Dr. Vlahos diagnosed a right foot strain and recommended 

physical therapy and modified duty.

On March 2, 2021 OWCP accepted appellant’s traumatic injury claim for a strain of 

unspecified muscle and tendon at the right ankle and foot. 

OWCP thereafter received a February 24, 2021 report by Dr. Vlahos indicating that 

appellant continued to report right foot pain, but had returned to working regular duty. On physical 

examination, she noted mild swelling in the arch and sole of the right foot, tenderness in the medial 

midfoot, and limited flexion and extension of the toes at the MTP joints. Dr. Vlahos diagnosed a 

strain of unspecified muscle or tendon at the right ankle and foot and recommended that appellant 

undergo a magnetic resonance imaging (MRI) scan of the right foot.

In a follow-up report dated March 4, 2021, Dr. Vlahos indicated that, at the time, appellant 

was working modified duty.

A March 8, 2021 MRI scan of the right forefoot dated March 8, 2021 demonstrated normal 

findings.

On March 8, 2021 appellant accepted a position as a modified city carrier casing and 

pulling down routes and performing simple grasping with the right hand for up to six hours per 

day.

In a follow-up report dated March 11, 2021, Dr. Vlahos reviewed appellant’s MRI scan, 

performed a physical examination, and referred him to a podiatrist.

In an operative report dated March 17, 2021, Dr. Vittorio Caterino, a podiatrist, excised a 

tumor of appellant’s right foot. He diagnosed an “unknown soft tissue mass” at the plantar aspect 

of the right foot.

On April 14, 2021 appellant filed a claim for compensation (Form CA-7) for the period

April 6 through 9, 2021. 

2

In follow-up reports dated February 3 and 10, 2021, Dr.Vlahos indicated that appellant was working modified 

duty.
3

In a development letter dated April 20, 2021, OWCP requested that appellant submit 

medical evidence to support the claimed period of disability from April 6 through 9, 2021 as 

causally related to the accepted February 1, 2021 employment injury. It afforded him 30 days to 

submit the requested evidence.

Beginning April 28, 2021, appellant filed CA-7 forms claiming wage-loss compensation 

for disability from work commencing April 10, 2021. 

In a development letter dated April 29, 2021, OWCP informed appellant of the deficiencies 

of his claim for compensation. It advised him of the type of evidence necessary to establish his 

claim and afforded him 30 days to respond. 

On May 5, 2021 OWCP received a partially legible duty status report (Form CA-17) from 

a provider with an illegible signature, which noted a history of a sprain of the right foot, and that 

appellant had undergone corrective foot surgery on March 17, 2021.3

By decision dated May 25, 2021, OWCP denied appellant’s disability claim, finding that 

the medical evidence of record was insufficient to establish that he was unable to work from

April 6 through 9, 2021 due to his accepted employment injury. It further found that he had not 

submitted sufficient medical evidence to support expansion of the acceptance of his claim to 

include a tumor in his right foot.

On June 2, 2021 appellant requested for reconsideration of OWCP’s May 25, 2021 

decision.

In a June 2, 2021 report, Dr. Caterino indicated that he first examined appellant for solid 

masses4 on the plantar aspect of his right foot on March 13, 2021 that had occurred “following a 

work-related foot injury.” He diagnosed plantar fibroma, which he indicated was “a condition 

caused by overstress and/or tear of the plantar fascia....” Dr. Caterino advised that he had 

performed surgical excision of the masses on March 17, 2021 that appellant was rehabilitating 

from surgery, and that he expected him to make a full recovery.

By decision dated June 3, 2021, OWCP denied appellant’s claim for disability from work 

commencing April 10, 2021, finding that the medical evidence of record was insufficient to 

establish that he was unable to work during the claimed period due to his accepted employment 

injury.

By decision dated August 18, 2021, OWCP denied modification of its May 25, 2021 

decision. 

LEGAL PRECEDENT -- ISSUE 1

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

essential elements of his or her claim including the fact that any disability or specific condition for 

3 The remainder of the document is not legible.

4 The Board notes that Dr. Caterino’s operative report indicates that he removed a single mass.
4

which compensation is claimed is causally related to the employment injury.5 For each period of 

disability claimed, the employee has the burden of proof to establish that he or she was disabled 

from work as a result of the accepted employment injury.6 Whether a particular injury causes an 

employee to become disabled from work, and the duration of that disability, are medical issues 

that must be proven by a preponderance of probative and reliable medical opinion evidence.7

Under FECA the term “disability” means the incapacity, because of an employment injury, 

to earn the wages that the employee was receiving at the time of injury. 8 When, however, the 

medical evidence establishes that the residuals or sequelae of an employment injury are such that, 

from a medical standpoint, they prevent the employee from continuing in his or her employment, 

he or she is entitled to compensation for loss of wages.9

To establish causal relationship between the disability claimed and the employment injury, 

an employee must submit rationalized medical evidence, based on a complete factual and medical 

background, supporting such causal relationship.10 The opinion of the physician must be based on 

a complete factual and medical background of the claimant, must be one of reasonable med ical 

certainty, and must be supported by medical rationale explaining the nature of the relationship 

between the diagnosed condition and the specific employment factors identified by the claimant.11

The Board will not require OWCP to pay compensation for disability in the absence of 

medical evidence directly addressing the specific dates of disability for which compensation is 

claimed. To do so would essentially allow an employee to self-certify his or her disability and 

entitlement to compensation.12

ANALYSIS -- ISSUE 1

The Board finds that appellant has not met his burden of proof to establish disability from 

work commencing April 6, 2021, causally related to his accepted February 1, 2021 employment 

injury.

5 C.B., Docket No. 20-0629 (issued May 26, 2021); S.W., Docket No. 18-1529 (issued April19, 2019); J.F., Docket 

No. 09-1061 (issued November 17, 2009).

6

See M.B., Docket No. 18-1455 (issued March11, 2019); D.W., Docket No. 18-0644 (issued November 15, 2018); 

Amelia S. Jefferson, 57 ECAB 183 (2005).

7

See 20 C.F.R. § 10.5(f); T.W., Docket No. 22-0790 (issued March 9, 2023); N.M., Docket No. 18-0939 (issued 

December 6, 2018).

8

20 C.F.R. § 10.5(f).

9

See L.S., Docket No. 22-0821 (issued March 20, 2023); D.R., Docket No. 18-0323 (issued October 2, 2018).

10 See L.S., id.; S.J., Docket No. 17-0828 (issued December 20, 2017); Kathryn E. DeMarsh, 56 ECAB 677 (2005).

11 Y.S., Docket No. 19-1572 (issued March 12, 2020); T.K., Docket No. 18-1239 (issued May 29, 2019).

12 See N.O., Docket No. 22-0644 (issued March 8, 2023); J.B., Docket No. 19-0715 (issued September 12, 2019); 

Fereidoon Kharabi, 52 ECAB 291 (2001).
5

On June 2, 2021 Dr. Caterino diagnosed plantar fibroma, and noted that this was a 

condition caused by over-stress and/or tear of the plantar fascia. He performed a surgical excision 

of masses on March 17, 2021. Dr. Caterino, however, did not provide an opinion indicating that 

appellant was unable to work during the claimed period due to the accepted February 1, 2021 

employment conditions.13 The Board has held that medical evidence that does not provide an 

opinion as to whether a period of disability is due to an accepted employment-related condition is 

insufficient to meet a claimant’s burden of proof.

14

 Therefore, Dr. Caterino’s report is insufficient 

to establish appellant’s claim for disability beginning April 6, 2021 and continuing.

In her February and March 2021 reports, Dr. Vlahos diagnosed a strain of unspecified 

muscle or tendon at the right ankle and foot. She did not, however, provide an opinion on 

appellant’s disability from work during the claimed periods beginning April 6, 2021 and 

continuing. As discussed, medical evidence that does not address the specific dates of disability 

claimed is of limited probative value.15 Therefore, these reports are insufficient to establish 

appellant’s disability claim.16

OWCP also received a partially legible Form CA-17 from a provider with an illegible 

signature. The Board has held that reports that are unsigned or bear an illegible signature cannot 

be considered probative medical evidence as the author cannot be identified as a physician. 17 

Therefore, thisreport is also of no probative value and is insufficient to establish appellant’s claim.

Finally, appellant submitted results from diagnostic testing. The Board has held that 

diagnostic studies, standing alone, are of limited probative value as they do not address whether 

the employment injury caused appellant to be disabled during the claimed period. 18 These reports 

are, therefore, insufficient to establish the claim.

As appellant has not submitted rationalized medical evidence establishing causal 

relationship between the claimed period of disability and the accepted employment injury, the 

Board finds that he has not met his burden of proof.

13 See T.T., Docket No. 18-1054 (issued April8, 2020); Y.D., Docket No. 16-1896 (issued February 10, 2017).

14 R.J., Docket No. 19-0179 (issued May 26, 2020); M.A., Docket No. 19-1119 (issued November 25, 2019); S.I., 

Docket No. 18-1582 (issued June20, 2019); L.B., Docket No. 18-0533 (issued August 27, 2018); D.K., Docket No. 

17-1549 (issued July 6, 2018).

15 See D.P., Docket No. 22-0184 (issued June7, 2022); T.S., Docket No 20-1229 (issued August6, 2021); J.M., 

Docket No. 19-1169 (issued February 7, 2020); A.L., 19-0285 (issued September 24, 2019);L.B., Docket No. 18-0533 

(issued August 27, 2018); D.K., Docket No. 17-1549 (issued July 6, 2018).

16 Id.

17 C.S., Docket No. 20-1354 (issued January 29, 2021); D.T., Docket No. 20-0685 (issued October 8, 2020); 

Merton J. Sills, 39 ECAB 572, 575 (1988).

18 See A.D., Docket No. 21-0143 (issued November 15, 2021); J.S., Docket No. 17-1039 (issued October 6, 2017).
6

LEGAL PRECEDENT -- ISSUE 2

When an employee claims that a condition not accepted or approved by OWCP was due to 

an employment injury, he or she bears the burden of proof to establish that the condition is causally 

related to the employment injury.19 When an injury arises in the course of employment, every 

natural consequence that flows from that injury likewise arises out of the employment, unless it is 

the result of an independent intervening cause attributable to the claimant’s own intentional 

misconduct.20 Thus, a subsequent injury, be it an aggravation of the original injury or a new and 

distinct injury, is compensable if it is the direct and natural result of a compensable primary 

injury.21

To establish causal relationship between a specific condition, as well as any attendant 

disability claimed, and the employment injury, an employee must submit rationalized medical 

evidence.22 The opinion of the physician must be based on a complete factual and medical 

background of the claimant, 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 factors identified by the claimant. 23

ANALYSIS -- ISSUE 2

The Board finds that appellant has not met his burden of proof to establish that his c laim 

should be expanded to include an additional condition as causally related to his accepted 

employment injury.

In his June 2, 2021 report, Dr. Caterino diagnosed plantar fibroma, and opined that the 

condition was caused by over-stress and/or tear of the plantar fascia. He did not, however, describe 

the accepted February 1, 2021 employment incident in detail or explain the pathophysiological 

process through which the employment incident could have caused appellant’s tumor or plantar 

fibroma. The Board has held that medical evidence that states a conclusion, but does not offer a 

rationalized medical explanation regarding the cause of an employee’s condition is of limited 

probative value on the issue of causal relationship.24 Therefore,Dr. Caterino’s June 2, 2021 report 

is insufficient to establish expansion of the claim.25

19 M.M., Docket No. 19-0951 (issued October 24, 2019); Jaja K. Asaramo, 55 ECAB 200 (2004).

20 See J.M., Docket No. 19-1926 (issued March 19, 2021); I.S., Docket No. 19-1461 (issued April30, 2020); see 

also Charles W. Downey, 54 ECAB 421 (2003).

21 J.M., id.; Susanne W. Underwood (Randall L. Underwood), 53 ECAB 139, 141 n.7 (2001).

22 See V.A., Docket No. 21-1023 (issued March 6, 2023); M.W., 57 ECAB 710 (2006); JohnD. Jackson, 55 ECAB 

465 (2004).

23 E.P., Docket No. 20-0272 (issued December 19, 2022); I.J., 59 ECAB 408 (2008).

24 See C.T., Docket No. 22-0013 (issued November 22, 2022); R.B., Docket No. 22-0173 (issued July 26, 2022);

A.P., Docket No. 20-1668 (issued March 2, 2022); D.H., Docket No. 17-1913 (issued December 13, 2018).

25 B.W., Docket No. 21-0536 (issued March 6, 2023); M.M., Docket No. 20-1557 (issued November 3, 2021).
7

In his March 17, 2021 operative report, Dr. Caterino diagnosed an “unknown soft tissue 

mass of the plantar aspect of the right foot.” He did not, however, offer an opinion as to the cause 

of that condition. Medical evidence which does not offer an opinion regarding the cause of an 

employee’s condition is of no probative value on the issue of causal relationship. 26 This evidence 

is, therefore, of no probative value and insufficient to establish expansion of the claim.

As the medical evidence of record is insufficient to establish expansion of the acceptance 

of the claim to include an additional condition as causally related to appellant’s accepted 

employment injury, the Board finds that he has not met his 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 his burden of proof to establish disability from 

work beginning April 6, 2021 and continuing, causally related to his accepted February 1, 2021

employment injury. The Board further finds that he has not met his burden of proof to establish 

that his claim should be expanded to include an additional condition causally related to or as a 

consequence of his accepted February 1, 2021 employment injury. 

26 A.P., Docket No. 18-1690 (issued December 12, 2019); J.H., Docket No. 19-0383 (issued October 1, 2019).
8

ORDER

IT IS HEREBY ORDERED THAT the May 25, June 3, and August 18, 2021 decisions 

of the Office of Workers’ Compensation Programs are affirmed.

Issued: July 24, 2023

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board