B.C. and Department of Veterans Affairs, West Los Angeles VA Medical Center (Board decision, March 21, 2025)

ECAB final decision. The Board affirmed OWCP's denial because a medical condition caused by the accepted incident was not established. 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 VA mechanical engineer reported several injuries after a vehicle struck him at work. The Board found the medical evidence did not adequately establish that a diagnosed condition was caused by the accepted incident. It upheld the denial.

Decision snapshot

• Authority: Federal Employees' Compensation Act, 5 U.S.C. § 8101 et seq.
• Outcome: Injury claim denied for lack of established medical causation.
• Key point: The incident alone did not prove a compensable medical condition.

Full text (ECAB public release)

United States Department of Labor
Employees’ Compensation Appeals Board

________
)
B.C., Appellant
)
)
and ) Docket No. 25-0318
)
Issued: March 21, 2025
DEPARTMENT OF VETERANS AFFAIRS,
)
WEST LOS ANGELES VA MEDICAL CENTER, )
Los Angeles, CA, Employer
)
__________ )

Appearances: Case Submitted on the Record
Appellant, pro se
Office of Solicitor, for the Director

DECISION AND ORDER

Before:
PATRICIA H. FITZGERALD, Deputy Chief Judge JANICE B. ASKIN, Judge
VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On February 18, 2025, appellant filed a timely appeal from a January 13, 2025 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.

ISSUE

The issue is whether appellant has met his burden of proof to establish a medical condition causally related to the accepted April 1, 2024 employment incident.

FACTUAL HISTORY

On April 8, 2024, appellant, then a 34-year-old mechanical engineer, filed a traumatic injury claim (Form CA-1) alleging that on April 1, 2024 he sustained injuries to the hips, left knee, left shin, and left arm when he was struck by a sport utility vehicle while in the performance of

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5 U.S.C. § 8101 et seq. duty. On the reverse of the claim form, the employing establishment acknowledged that appellant was in the performance of duty.

Appellant submitted a note dated April 1, 2024 from a provider with an illegible signature, noting work restrictions. He also submitted a report of emergency treatment at the employing establishment dated April 8, 2024 from Teneka Hosang, a physician assistant, which noted work restrictions. OWCP received illegible progress notes dated April 9, 2024.

In a development letter dated April 12, 2024, OWCP informed appellant of the deficiencies of his claim. It advised him of the type of additional factual and medical information needed and provided a questionnaire for completion. OWCP afforded appellant 60 days to submit the necessary evidence. No additional evidence was received.

In a follow-up development letter dated May 9, 2024, OWCP advised appellant that it had conducted an interim review, and the evidence remained insufficient to establish his claim. It noted that he had 60 days from the April 12, 2024 letter to submit the requested necessary evidence. 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.

Appellant submitted work restrictions from providers with illegible signatures dated April 16 through May 14, 2024. He also submitted reports from nurse practitioners dated April 9 through May 20, 2024.

In correspondence dated April 5, 2024, Kathleen Griffin, a nurse practitioner, informed appellant that he did not have a fracture, but that he did have an incidental finding of avascular necrosis (AVN) at the bilateral femoral heads. She further noted that an x-ray of his knee was normal.

In a report dated April 9, 2024 by Dr. Martin Tynan, an orthopedic trauma surgeon, appellant was evaluated for being struck by a vehicle on April 2, 2024. X-rays obtained on April 1 and 9, 2024 demonstrated AVN at the bilateral femoral heads manifest by serpiginous sclerosis. A computerized tomography (CT) scan obtained in May 2020 demonstrated mottled sclerosis of the bilateral femoral heads extending to the articular surface and subtle deformity of the left femoral head without significant collapse. Appellant was noted to be currently asymptomatic.

Appellant submitted a report dated May 17, 2024 signed by Greta Manila, a nurse practitioner, which indicated that appellant’s magnetic resonance imaging (MRI) scan of the bilateral hips revealed AVN without collapse.

In progress notes dated June 6, 2024, Ms. Manila informed Ms. Griffin that appellant was scheduled for “left hip surgical core decompression for his bilateral AVN […] due to alcohol, steroid, radiation therapy, etc., but not trauma.”

By decision dated June 21, 2024, OWCP denied appellant’s claim, finding that the medical evidence of record was insufficient to establish causal relationship between his diagnosed bilateral AVN of the hips and the accepted April 1, 2024 employment incident.

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On December 30, 2024, appellant requested reconsideration. In support thereof, he provided an April 10, 2024 report wherein Dr. Michael Coburn 2 reviewed appellant’s history of injury, noting that he had been struck by a motor vehicle as a pedestrian. Dr. Coburn related appellant’s complaints of muscle weakness, muscle pain or tenderness, shoulder pain, back pain, hip pain, knee pain, gait disturbance, and headaches. On physical examination, appellant demonstrated pain on anterior flexion of the neck; evidence of crepitation, laxity, or instability on palpation of the thoracic spine; increased pain on hyperextension of the thoracic spine; pain with lumbar extension; tenderness on palpation over the left posterior glenohumeral joint; and tenderness on palpation to the left knee. Dr. Coburn diagnosed acute post-traumatic headache, and pain of the back, mid-back, hip, knee, and shoulder.

By decision dated January 13, 2025, OWCP denied modification of its June 21, 2024 decision.

LEGAL PRECEDENT

An employee seeking benefits under FECA 3 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, 4 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. 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 comp onent 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 an injury. 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

2
Dr. Coburn’s Board certification in a medical specialty could not be confirmed.
3
Supra note 1.
4
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). 5 L.C., Docket No. 19-1301 (issued January 29, 2020); J.H., Docket No. 18-1637 (issued January 29, 2020); R.C., 59 ECAB 427 (2008); 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).

3 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 incident. 9 Neither the mere fact that a disease or condition manifests itself during a period of employment, nor the belief that the disease or condition was caused or aggravated by employment factors or incidents is sufficient to establish causal relationship. 10

ANALYSIS

The Board finds that appellant has not met his burden of proof to establish a medical condition causally related to the accepted April 1, 2024 employment incident.

In an April 9, 2024 report, by Dr. Tynan, appellant was evaluated for being struck by a vehicle on April 2, 2024. This evidence, however, did not contain an opinion as to causal relationship between a diagnosed medical condition and the accepted April 1, 2024 employment incident. The Board has held that medical evidence that does not offer an opinion regarding the cause of an employee’s condition is of no probative value. 11 As such, this evidence is insufficient to establish appellant’s claim.

Appellant also submitted a report dated April 10, 2024 by Dr. Coburn, containing diagnoses of acute post-traumatic headache, and pain of the back, mid-back, hip, knee, and shoulder. The April 10, 2024, however, did not contain an opinion as to causal relationship.12 This evidence is therefore of no probative value and is insufficient to establish appellant’s claim.

OWCP received evidence signed solely by physician assistants and nurse practitioners.
However, certain healthcare providers such as nurses and physician assistants are not considered physicians as defined under FECA. 13 Thus, this evidence is of no probative value and is insufficient to establish appellant’s claim.

OWCP also received evidence containing illegible signatures and illegible content. The Board has held that reports that are unsigned or bear an illegible signature lack proper identification

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F.S., Docket No. 23-0112 (issued April 26, 2023); 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). 10 L.W., Docket No. 24-0947 (issued January 31, 2025); T.H., Docket No. 18-1736 (issued March 13, 2019);
Dennis M. Mascarenas, 49 ECAB 215 (1997).
11
G.K., Docket No. 23-1060 (issued January 9, 2024); J.H., Docket No. 20-1414 (issued April 5, 2022);
L.B., Docket No. 18-0533 (issued August 27, 2018); D.K., Docket No. 17-1549 (issued July 6, 2018). 12 See id.
13
Section 8101(2) of FECA provides that medical opinions can only be given by a qualified physician. This section 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 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) (May 2023); J.B., Docket No. 24-0946 (issued November 4, 2024) (finding that a physician assistant and nurse practitioner are not considered physicians as defined under FECA); 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).

4 and cannot be considered probative medical evidence as the author cannot be identified as a physician.14

As the medical evidence of record is insufficient to establish a medical condition causally related to the accepted April 1, 2024 employment incident, the Board finds that appellant 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 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 a medical condition causally related to the accepted April 1, 2024 employment incident.

ORDER

IT IS HEREBY ORDERED THAT the January 13, 2025 decision of the Office of Workers’ Compensation Programs is affirmed.

Issued: March 21, 2025
Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge Employees’ Compensation Appeals Board

Janice B. Askin, Judge
Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge Employees’ Compensation Appeals Board

14
See A.B., Docket No. 25-0057 (issued November 26, 2024); B.S., Docket No. 22-0918 (issued August 29, 2022);
S.D., Docket No. 21-0292 (issued June 29, 2021); C.B., Docket No. 09-2027 (issued May 12, 2010); Merton J. Sills, 39 ECAB 572, 575 (1988).

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