R.G. and U.S. Postal Service, Michigan Metroplex Processing and Distribution Center (Board decision, May 12, 2025)

ECAB final decision. The Board affirmed OWCP's denial of the injury claim. 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 processing clerk reported wrist and neck injuries after a box struck her at work. The Board accepted the work incident but found the physicians' reports did not explain whether it caused a diagnosed medical condition. It affirmed OWCP's denial of the claim.

Decision snapshot

• Authority: Federal Employees' Compensation Act, 5 U.S.C. § 8101 et seq.
• Outcome: Injury claim denial affirmed.
• Key point: Medical reports describing symptoms and restrictions did not establish the required causal connection.

Full text (ECAB public release)

United States Department of Labor
Employees’ Compensation Appeals Board

________
)
R.G., Appellant
)
)
and ) Docket No. 25-0342
)
Issued: May 12, 2025
U.S. POSTAL SERVICE, MICHIGAN
)
METROPLEX PROCESSING AND
)
DISTRIBUTION CENTER, Pontiac, MI, )
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 25, 2025 appellant filed a timely appeal from a December 4, 2024 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

1
5 U.S.C. § 8101 et seq.
2
The Board notes that, following the December 4, 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 September 9, 2024 employment incident.

FACTUAL HISTORY

On September 19, 2024 appellant, then a 40-year-old mail processing clerk, filed a traumatic injury claim (Form CA-1) alleging that on September 9, 2024 she sustained a neck and left wrist injury when a box weighing around 15 pounds struck her in the face and on the left hand while in the performance of duty. On the reverse side of the claim form, the employing establishment controverted the claim, contending that she was injured prior to the incident as she had reported to work on her first day with a brace on her left hand and stated that the injury occurred elsewhere. Appellant stopped work on September 13, 2024.

In support of her claim, appellant submitted additional factual and medical evidence. In a statement dated September 12, 2024, she reported that on September 10, 2024, between 8:00 and 10:00 p.m., she was processing mail when she lifted a box on a machine and one of the boxes rolled off, striking her in her face, which left a red mark on her face and neck extending to her back. Appellant reported that two other employees were working on the conveyer belt loading packages at the time of her injury. She reported notifying her manager twice about the incident but received no assistance. Despite treating her face and neck at home, appellant’s pain worsened causing her to report her condition on September 12, 2024. Along with her statement, she submitted a September 9, 2024 documented discussion with the employing establishment regarding workplace safety at the sips machine.

Appellant submitted a September 13, 2024 work restriction note from a provider with an illegible signature, which noted that she was seen in the emergency department on that date and could return to work on September 16, 2024.

In a September 16, 2024 report, Dr. Zulekha Ali, a Board-certified internist, restricted appellant from returning to work from September 17 through 23, 2024. He also provided cervical sprain and strain rehabilitation instructions and exercises.

In a September 19, 2024 report, Dr. Michael Korn, an orthopedic surgeon, reported that appellant could return to light-duty work with restrictions of no lifting with the left hand. He indicated that she must wear a wrist brace at all times and provided the restrictions through October 20, 2024.

In a letter received on September 26, 2024, the employing establishment controverted appellant’s traumatic injury claim, contending that she refused medical treatment on September 9, 2024 following the injury and did not seek treatment until September 16, 2024. It further reiterated that she had reported to work on her first day wearing a brace on her hand and was seeking a way to obtain work restrictions for a preexisting injury, noting that the September 16, 2024 restrictions provided by her physician applied only to her hand when she alleged a work-related head injury.

2
OWCP also received an official job description for a postal support employee (PSE) mail processing clerk, and photographs documenting the employment incident.

In a September 30, 2024 development letter, OWCP informed appellant of the deficiencies of her claim. It advised her of the type of factual and medical evidence needed 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 ambulatory referral to neurology dated September 30, 2024 from Dr. Kevin Taliaferro, a Board-certified orthopedic surgeon, who diagnosed cervicalgia and cervical radiculopathy.

Appellant also submitted a September 30, 2024 progress note from Renee Jenkinson, a nurse practitioner, documenting treatment for an August 26, 2024 work-related injury when a box full of packages struck her in the face, causing her to use her wrist to protect her face. She diagnosed cervicalgia and cervical radiculopathy.

In an October 1, 2024 letter, the employing establishment reported that appellant resigned from her position on September 19, 2024. It noted that she also provided medical documentation for return-to-work restrictions that same date.

In an October 2, 2024 statement, appellant described the circumstances surrounding her injury when a package struck her in the face. She asserted that prior to this incident, she had no history of left hand or wrist injuries, and the injuries she sustained on September 9, 2024 were entirely related to this specific employment incident.

In a letter received on October 3, 2024, A.H., an employing establishment supervisor, reported that appellant had initially claimed that the incident occurred on September 10, 2024, but she was off work that day. She later clarified that the injury occurred on September 9, 2024. The employing establishment provided witness statements, which it alleged called into question the circumstances surrounding the alleged injury.

In an October 10, 2024 report, Dr. Korn reported that appellant returned for follow-up of a left wrist injury that occurred on September 9, 2024 when a 15-pound box fell on her wrist at work. He noted last evaluating appellant on September 19, 2024, where she complained of continued left wrist pain and described difficulty carrying heavy objects because of the pain. Dr. Korn reported that appellant had been intermittently wearing a thumb spica brace and was also seeking treatment for her cervical spine. He diagnosed left wrist sprain, which was consistent with her left wrist magnetic resonance imaging (MRI) scan that demonstrated some evidence of injury to the scapholunate ligament of the left wrist. Dr. Korn administered an intra-articular injection. An October 10, 2024 x-ray of the left wrist revealed bilateral scapholunate widening.

In a follow-up letter dated October 25, 2024, OWCP advised appellant that it had conducted an interim review, and that the evidence remained insufficient to establish her claim. It noted that she had 60 days from the September 30, 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.

3
In response to OWCP’s letter, appellant submitted a November 20, 2024 statement describing the circumstances surrounding her claim and medical treatment for her injury. She also provided screenshots of text messages exchanged with a coworker who had witnessed the September 9, 2024 employment incident when appellant’s glasses were knocked off her face, as well as a note from a retail store verifying that her glasses were being repaired.

In an October 7, 2024 report, Dr. David D. Kim, a Board-certified physiatrist, reported that appellant had a history of a motor vehicle accident from seven years prior, which resulted in a C5- 6 fusion. Appellant reported seeking treatment at the emergency room the prior year due to tingling in her left arm and neck. Dr. Kim reviewed a December 20, 2023 cervical spine MRI scan, which revealed a large C6-7 disc extrusion with compression on the cord and subtle cord signal changes. He reported that appellant was working at the employing establishment and was hit by a box in the left wrist and head with worsening of her usual headaches and wrist pain and increased neck pain with radiation to both arms and some tingling. Given the large size of disc extrusion and faint cord signal changes, Dr. Kim reported that appellant may not respond to conservative therapy and would require surgery for relief of her condition .

Appellant also submitted a November 12, 2024 progress report from Aliah Sareini, a nurse practitioner; massage therapy reports dated November 13 and 21, 2024; and a November 16, 2024 MRI scan of the cervical spine, which revealed multilevel mild disc degeneration.

By decision dated December 4, 2024, OWCP denied appellant’s claim, finding that the evidence of record was insufficient to establish a medical condition causally related to the accepted September 9, 2024 employment incident.

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. First, the employee must submit sufficient evidence to establish that he or she actually experienced the 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 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). 6 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).

4 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. 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 incident identified by the employee. 9

ANALYSIS

The Board finds that appellant has not met her burden of proof to establish a medical condition causally related to the accepted September 9, 2024 employment incident.

In reports dated September 19 and October 10, 2024, Dr. Korn provided work restrictions and reported that appellant sustained a left wrist injury on September 9, 2024 when a 15-pound box fell on her wrist at work. He noted complaints of continued left wrist pain and difficulty carrying heavy objects due to pain. Dr. Korn reported that appellant had been intermittently wearing a thumb spica brace, her symptoms were consistent with wrist sprain, and her MRI scan revealed some evidence of injury to the scapholunate ligament of the left wrist. However, he failed to provide an opinion on causal relationship. 10 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.

In an October 7, 2024 report, Dr. Kim opined that appellant may not respond to conservative therapy and would require surgery for relief of her condition. However, he did not provide an opinion on causal relationship between a diagnosed medical condition and the accepted September 9, 2024 employment incident. Therefore, this report is of no probative value and is insufficient to establish the claim.12 As such, this evidence is insufficient to establish appellant’s claim.

7
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). 8 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). 9 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). 10 See P.C., Docket No. 25-0249 (issued March 3, 2025); D.C., Docket No. 18-1425 (issued March 15, 2019).
11
J.H., Docket No. 24-0748 (issued September 20, 2024); G.M., Docket No. 24-0388 (issued May 28, 2024);
L.B., Docket No. 18-0533 (issued August 27, 2018); D.K., Docket No. 17-1549 (issued July 6, 2018). 12 Id.

5
Dr. Ali’s September 16, 2024 report is also insufficient to establish appellant’s claim as the physician likewise failed to provide an opinion on causal relationship. Therefore, his opinion is of no probative value and is insufficient to establish the claim.13

OWCP also received evidence from a provider with an illegible signature. 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.14

Appellant also submitted treatment notes from a nurse practitioner and massage therapists.
However, certain healthcare providers such as nurses and therapists are not considered physicians as defined under FECA and their reports do not constitute competent medical evidence. 15 Consequently, these medical findings or opinions are insufficient to meet appellant’s burden of proof.16

The remaining evidence of record consists of an October 10, 2024 x-ray of the left wrist and November 16, 2024 MRI scan of the cervical spine. The Board, however, has held that diagnostic studies, standing alone, lack probative value as they do not address whether the accepted September 9, 2024 employment incident caused the diagnosed condition. 17 For this reason, these reports are insufficient to establish appellant’s claim.

As the medical evidence of record is insufficient to establish causal relationship between a medical condition and the accepted September 9, 2024 employment incident, the Board finds that appellant has not met her burden of proof. 18

13
Id.
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). 15 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) (January 2013); 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 B.D., Docket No. 22-0503 (issued September 27, 2022) (nurse practitioners are not considered physicians as defined under FECA and their medical findings and/or opinions will not suffice for purposes of establishing entitlement to FECA benefits); L.S., Docket No. 19-1231 (issued March 30, 2021) (a nurse practitioner is not considered a physician as defined under FECA); Audrey Wheat, Docket No. 00-1442 (issued May 7, 2002) (massage therapists are not defined as physicians under FECA). 16 T.H., Docket No. 23-1142 (issued March 28, 2024).
17
F.D., Docket No. 19-0932 (issued October 3, 2019).
18
I.D., Docket No. 22-0848 (issued September 2, 2022); T.G., Docket No. 14-751 (issued October 20, 2014).

6
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 September 9, 2024 employment incident.

ORDER

IT IS HEREBY ORDERED THAT the December 4, 2024 decision of the Office of Workers’ Compensation Programs is affirmed.

Issued: May 12, 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

7