L.B. and U.S. Postal Service, Northwest Longview Post Office (Board decision, March 17, 2025)

ECAB final decision. The Board affirmed OWCP's denial of a neck condition attributed to a July 2024 work incident. A party may petition the Board for reconsideration within 30 days of issuance unless this order specifies another period, under 20 C.F.R. § 501.7(a). FECA compensation decisions are generally not subject to court review under 5 U.S.C. § 8128(b).

Plain-English summary

A postal mail handler reported neck pain after loading unexpectedly heavy packages. The Board found the medical evidence did not adequately connect a diagnosed neck condition to the accepted incident. It upheld the denial.

Decision snapshot

• Authority: Federal Employees' Compensation Act, 5 U.S.C. § 8101 et seq.
• Outcome: Neck-condition claim denied.
• Key point: The record did not establish medical causation from the package-loading incident.

Full text (ECAB public release)

United States Department of Labor
Employees’ Compensation Appeals Board

________
)
L.B., Appellant
)
)
and ) Docket No. 25-0269
)
Issued: March 17, 2025
U.S. POSTAL SERVICE, NORTHWEST
)
LONGVIEW POST OFFICE, Coppell, TX, )
Employer
)
__________ )

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 January 13, 2025 appellant filed a timely appeal from a December 5, 2024 merit decision and a December 4, 2024 nonmerit 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 December 5, 2024 decision, appellant submitted additional evidence to OWCP. 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.
ISSUE

The issue is whether appellant has met her burden of proof to establish a medical condition causally related to the accepted July 25, 2024 employment incident.

FACTUAL HISTORY

On July 29, 2024 appellant, then a 33-year-old mail handler, filed a traumatic injury claim (Form CA-1) alleging that on July 25, 2024 she sustained a neck injury when she was loading packages into a mail truck, that were unknowingly heavy, while in the performance of duty. She stopped work on July 25, 2024.

A July 26, 2024 magnetic resonance imaging (MRI) scan of the cervical spine demonstrated an impression of mild spinal canal stenosis at C5-6 and minimal bilateral foraminal stenosis at C5-6 from disc bulging.

Appellant submitted a duty status report (Form CA-17) dated August 7, 2024 from Latrina Martin, a nurse practitioner, who noted work restrictions and diagnosed neck and thoracic pain with movement.

In an August 8, 2024 development letter, OWCP informed appellant of the deficiencies of her claim. It advised her of the type of factual and medical evidence required and provided a questionnaire for her completion. OWCP afforded appellant 60 days to submit the necessary evidence.

In response to the development letter, appellant submitted an emergency room discharge summary dated July 26, 2024 from Meghann Bybee, an advanced practice registered nurse, who provided an off work note and diagnosed urinary tract infection, neck pain -- pinched nerve, cervical radiculopathy, cervical disc disease, nausea, and dehydration.

In a July 31, 2024 statement, appellant described the employment incident where she delivered four packages without a heavy label and after bending over into an orange tub to load up her truck, she felt a strain on her neck. She noted that she continued to work, but reported that the following day, Friday, July 26, 2024, she could barely get out of bed and went to the emergency room where she underwent an MRI scan, which demonstrated a herniated disc in her neck. Appellant reported that it was a busy week and the package load was extremely heavy.

In a letter received on August 17, 2024, the employing establishment challenged appellant’s traumatic injury claim, alleging that she failed to call management to report the accident and investigate appropriately.

Appellant also submitted an August 26, 2024 Form CA-17 from Ms. Martin who diagnosed neck and thoracic pain with movement and restricted her from working.

In a follow-up development letter dated September 26, 2024, OWCP advised appellant that it had conducted an interim review, and the evidence remained insufficient to establish her claim. It noted that she had 60 days from the August 8, 2024 letter to submit the necessary evidence.

2
OWCP further advised that if the evidence was not received during this time, it would issue a decision based on the evidence contained in the record.

In response to OWCP’s development letter, appellant submitted a September 9, 2024 medical report from Dr. Muhammad Arif, Board-certified in pain medicine. Dr. Arif reported that appellant was a patient at his clinic for a previous work injury when she presented for evaluation of a new injury after lifting a package that was not marked as heavy. Appellant reported that once she lifted the package, she felt immediate pain on the right side of her neck that progressively increased in intensity, causing her to seek treatment at the emergency room the following day due to pain. She further complained of pain and weakness to the right hand, specifically to the last three fingers. Dr. Arif noted examining appellant following her new injury on July 31, August 20 and 26, and September 5, 2024, where she reported weakness and stabbing pain with activities that required the use of her arms, including brushing her teeth. He discussed examination findings, which exhibited a positive Spurling test on the right side, cervical facet tenderness, and midline tenderness. Dr. Arif further reviewed the July 26, 2024 MRI scan, which demonstrated an impression of mild spinal stenosis at C5-6 and bulging with minimal bilateral foraminal stenosis at C5-6. He ordered a physical therapy evaluation, intra-articular injection, and restricted appellant from returning to work pending an evaluation for safe lifting. Dr. Arif explained that both physical therapy and an intra-articular injection would help reduce radicular symptoms, and time off work would improve the chances of returning to her previous level of functionality.

By decision dated October 18, 2024, OWCP denied appellant’s claim, finding that the medical evidence of record was insufficient to establish an injury causally related to the accepted July 25, 2024 employment incident.

Following OWCP’s decision, appellant submitted an October 17, 2024 Form CA-17, wherein Ms. Martin diagnosed neck and thoracic pain with movement and restricted her from working.

On November 26, 2024, appellant requested a review of the written record and an oral hearing before a representative of OWCP’s Branch of Hearings and Review. She also submitted a request for reconsideration.

In support thereof, she submitted a November 19, 2024 functional capacity evaluation (FCE). The report contained an illegible signature.

Appellant also submitted a November 26, 2024 attending physician’s report (Form CA-20) wherein Dr. Arif discussed the history of injury noting that appellant picked up a package, not marked heavy, while at work. He diagnosed spinal stenosis at C5-6 and bulging disc at C5-6, which correlated with the result of the November 19, 2024 FCE. Dr. Arif reported that appellant was partially disabled, commencing July 25, 2024, and it was unknown when she would be able to return to full-duty work.

By decision dated December 4, 2024, OWCP denied appellant’s request for an oral hearing or review of the written record, finding that the request was not made within 30 days of the October 18, 2024 decision and, therefore, was untimely filed. It further exercised its discretion

3 and determined that the issue in the case could equally well be addressed through a request for reconsideration before OWCP along with the submission of new evidence.

By decision dated December 5, 2024, OWCP denied modification of its October 18, 2024 decision.3

LEGAL PRECEDENT

An employee seeking benefits under FECA 4 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, 5 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. 6 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. 7

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. First, 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. Second, the employee must submit sufficient medical evidence to establish that the employment incident caused an injury. 8

The medical evidence required to establish causal relationship between a claimed specific condition and an employment incident is rationalized medical opinion evidence. 9 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
OWCP noted that appellant had prior claims under OWCP File Nos. xxxxxx144; xxxxxx723; and xxxxxx609 involving thoracic and lumbar conditions. However, as appellant had clarified that this case involved only injury to the cervical spine and neck, it determined that those cases would not be administratively combined with the current claim. 4 Supra note 1.
5
E.K., Docket No. 22-1130 (issued December 30, 2022); 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). 6 S.H., Docket No. 22-0391 (issued June 29, 2022); 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). 7 E.H., Docket No. 22-0401 (issued June 29, 2022); 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). 8 H.M., Docket No. 22-0343 (issued June 28, 2022); T.J., Docket No. 19-0461 (issued August 11, 2020);
K.L., Docket No. 18-1029 (issued January 9, 2019); John J. Carlone, 41 ECAB 354 (1989). 9 S.M., Docket No. 22-0075 (issued May 6, 2022); 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).

4 nature of the relationship between the diagnosed condition and specific employment incident identified by the employee. 10

ANALYSIS

The Board finds that appellant has not met her burden of proof to establish a medical condition causally related to the accepted July 25, 2024 employment incident.

In support of her claim, appellant submitted medical reports from Dr. Arif dated September 9 and November 26, 2024, wherein he documented appellant’s treatment for her claimed July 25, 2024 injury, clinical findings, and history of injury. Dr. Arif diagnosed mild spinal stenosis at C5-6 and bulging with minimal bilateral foraminal stenosis at C5-6 and restricted appellant from returning to work. However, he did not provide an opinion on the cause of the diagnosed medical conditions. The Board has held that medical evidence that does not offer an opinion regarding the cause of an employee’s condition or disability is of no probative value on the issue of causal relationship.11 Therefore, this evidence is insufficient to establish appellant’s claim.

Appellant also submitted a January 14, 2024 emergency department report from Ms. Bybee, an advanced practice registered nurse, and Form CA-17 reports from Ms. Martin, a nurse practitioner. The Board has held that health care providers such as nurses, physician assistants, and physical therapists are not considered physicians as defined under FECA and their reports do not constitute competent medical evidence.12 Consequently, these medical findings or opinions are insufficient to meet appellant’s burden of proof.

10
J.D., Docket No. 22-0935 (issued December 16, 2022); 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). 11 G.M., Docket No. 24-0388 (issued May 28, 2024); C.R., Docket No. 23-0330 (issued July 28, 2023); K.K., Docket No. 22-0270 (issued February 14, 2023); S.J., Docket No. 19-0696 (issued August 23, 2019); M.C., Docket No. 18-0951 (issued January 7, 2019); L.B., Docket No. 18-0533 (issued August 27, 2018); D.K., Docket No. 17-1549 (issued July 6, 2018). 12 Section 8102(2) of FECA provides as follows: (2) 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. § 8102(2); 20 C.F.R. § 10.5(t). See Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.805.3a(1) (May 2023); 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); see also R.P., Docket No. 25-0054 (issued December 9, 2024) (nurse practitioners are not physicians under FECA); E.A., Docket No. 24-0937 (issued October 24, 2024) (advanced practice registered nurses are not considered physicians as defined under FECA and, therefore, are not competent to provide a medical opinion); P.S., Docket No. 17-0598 (issued June 23, 2017) (registered nurses are not considered physicians as defined under FECA).

5
Appellant also submitted a July 26, 2024 MRI scan of the cervical spine. The Board has held that diagnostic testing reports, standing alone, lack probative value. 13 Consequently, this evidence is insufficient to establish appellant’s claim.14

As the medical evidence of record is insufficient to establish a medical condition causally related to the accepted July 25, 2024 employment incident, the Board finds 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.

CONCLUSION

The Board finds that appellant has not met her burden of proof to establish a medical condition causally related to the accepted July 25, 2024 employment incident.

13
K.A., Docket No. 23-0613 (issued April 22, 2024); W.L., Docket No. 20-1589 (issued August 26, 2021); A.P., Docket No. 18-1690 (issued December 12, 2019).
14
D.S., Docket No. 24-0888 (issued November 6, 2024); A.W., Docket No. 22-1196 (issued November 23, 2022);
S.W., Docket No. 21-1105 (issued December 17, 2021); W.L., id.

6
ORDER

IT IS HEREBY ORDERED THAT the December 5, 2024 decision of the Office of Workers’ Compensation Programs is affirmed.

Issued: March 17, 2025
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

7