The executive branch plays a vital role in the federal courts under the US Constitution. The President appoints judicial nominees who can, with the consent of the Senate, become federal judges. Within the structure and hierarchy of the federal court system, the specialty courts and tribunals, such as the Court of Appeals for Veterans Claims, are at the initial level of the court system. Decisions from the Occupational Safety and Health Review Commission can be appealed to the federal district court in the District of Columbia or in the local federal district court. The federal district courts are strategically located throughout the states, as well as in the District of Columbia, Puerto Rica, Guam, the US Virgin Islands, and the Northern Mariana Islands. Each state has at least one federal trial court, and each district includes a US bankruptcy court as part of the federal district court structure.