RECOMMENDED FOR FULL-TEXT PUBLICATION 

Pursuant to Sixth Circuit I.O.P. 32.1(b) 

File Name: 17a0143p.06 

UNITED STATES COURT OF APPEALS

FOR THE SIXTH CIRCUIT 

GARY EDWARD WILLIAMSON, 

Plaintiff-Appellee/Cross-Appellant, 

v. 

UNITED STATES OF AMERICA, 

Defendant-Appellant/Cross-Appellee. 

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Nos. 16-5979/6105 

Appeal from the United States District Court 

for the Eastern District of Kentucky at Lexington. 

No. 5:12-cv-00334—Joseph M. Hood, District Judge. 

Argued: March 16, 2017 

Decided and Filed: July 10, 2017 

 Before: BOGGS, ROGERS, and COOK, Circuit Judges. 

_________________ 

COUNSEL 

ARGUED: Caroline D. Lopez, UNITED STATES DEPARTMENT OF JUSTICE, Washington, 

D.C., for Appellant/Cross-Appellee. Jerome P. Prather, GARMER & PRATHER, PLLC, 

Lexington, Kentucky, for Appellee/Cross-Appellant. ON BRIEF: Caroline D. Lopez, Mark B. 

Stern, UNITED STATES DEPARTMENT OF JUSTICE, Washington, D.C., for 

Appellant/Cross-Appellee. Jerome P. Prather, William R. Garmer, GARMER & PRATHER, 

PLLC, Lexington, Kentucky, for Appellee/Cross-Appellant. 

_________________ 

OPINION 

_________________ 

 ROGERS, Circuit Judge. After recovering what amounted to workers’ compensation 

benefits under the Federal Employees’ Compensation Act (FECA) for injuries incurred as a 

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postal worker, plaintiff Gary Williamson sought damages under the Federal Tort Claims Act 

(FTCA) for medical malpractice on the part of the Department of Veterans Affairs in the 

treatment of those injuries. Liability under FECA, however, is “exclusive” of “all other liability 

of the United States” to the employee “under a Federal tort liability statute.” 5 U.S.C. § 8116(c) 

(2012). Because this exclusion applies broadly even when a work-related injury has been 

negligently treated by an entirely non-work-related federal hospital, plaintiff Williamson may not 

recover under the FTCA. 

At the end of September or the beginning of October 2009, Gary Williamson, an Army 

veteran and U.S. postal worker, began experiencing pain in his right foot. At that time, he was a 

mail carrier for the U.S. Postal Service (USPS) in Lexington, Kentucky. He usually worked a 

walking route, walking up to eight miles per day on the job. He was also doing other physical 

activity around that time, including running and CrossFit, which could have contributed to his 

injury.

 Williamson first visited the VA Emergency Department (VA ED) for his foot pain on 

October 26, 2009. The treating physician took X-rays and diagnosed Williamson with a sprain, 

but at trial, Williamson’s medical expert testified that the October 26 X-rays show a navicular 

fracture in Williamson’s right foot. Williamson next visited the VA ED on November 27, 2009, 

after stepping in a hole along his mail route and twisting his ankle. Again, X-rays were taken, 

and again the treating physician found no fracture. 

Williamson’s pain persisted after a third visit to the VA in December. Later in 

December, Williamson’s primary care doctor referred him to a podiatrist at the VA. On 

January 20, 2010, the podiatrist diagnosed Williamson with a navicular fracture in his right foot 

and prescribed “a CAM walker—a removable boot used to offload pressure from a patient’s 

foot.” Williamson’s medical expert testified that this treatment plan violated the standard of care 

for treating a navicular fracture, which is six weeks of no weight-bearing in a cast. About one 

week later, Williamson applied for FECA benefits pursuant to his USPS employment, listing the 

tripping incident as the “cause of injury.” 
Nos. 16-5979/6105 Williamson v. United States Page 3

When Williamson did not show improvement in March, the VA podiatrist recommended 

surgery. The podiatrist performed an unsuccessful surgery on April 6 and a second surgery on 

April 21. Williamson continued to experience pain throughout the summer of 2010. In August, 

he visited a non-VA orthopedist, who referred him to an orthopedic surgeon at the University of 

Kentucky. The surgeon performed surgery in August 2010, which was successful, and a followup surgery in October 2013. Williamson still has lingering pain from his foot injury. 

 As noted, Williamson applied for benefits under FECA about two months after the 

November 2009 incident—when he tripped in a hole on his mail route. He eventually received a 

total of $127,155.12 in FECA benefits—“$79,379.66 in temporary total disability net 

compensation from March 20, 2010[,] through October 25, 2012”; $27,801.27 for medical 

expenses; and $19,974.19 as a lump-sum “schedule award.” 

Williamson filed the present suit against the United States under the FTCA on 

November 1, 2012. He claimed the VA was negligent in mistreating him during the October, 

November, and December visits, in failing to prescribe him non-weight-bearing treatment after 

the January diagnosis, and in performing the April surgeries. In response, the Government filed 

a motion for summary judgment, arguing that, under FECA’s exclusive-remedy provision, 

5 U.S.C. § 8116(c), when the Secretary of Labor has granted FECA benefits to a federal 

employee for a work-related injury, the employee may not then sue the United States in tort over 

the injury. 

The district court denied the Government’s motion for summary judgment. See 

Williamson v. United States, No. 5:12-cv-334-JMH, 2013 WL 4785689, at *6 (E.D. Ky. Sept. 5, 

2013). In doing so, the court recognized that its decision turned on two relevant Sixth Circuit 

cases: Wright v. United States, 717 F.2d 254 (6th Cir. 1983), and McCall v. United States, 901 

F.2d 548 (6th Cir. 1990). An alternative analysis in Wright relied on the dual-capacity 

doctrine—under which an employee may sue his employer in tort over an injury after receiving 

workers’ compensation benefits for the injury if the employer incurred tort liability while acting 

in a persona independent from its status as employer—as an exception to FECA’s exclusiveremedy provision. Wright, 717 F.2d at 259. Seven years later, faced with circumstances similar 

to those presented in Wright, we held in McCall that a federal-employee plaintiff was barred 
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from suing the United States for medical malpractice that aggravated an injury she had suffered 

at work after she had been awarded FECA benefits for the initial injury. McCall, 901 F.2d at 

552. In so holding, we expressly declined to apply the dual-capacity doctrine described in 

Wright, reasoning that Wright’s alternative holding is limited to the “unique circumstances” of 

that case. Id. at 551. In denying the Government’s motion for summary judgment, the district 

court reasoned that Williamson’s situation resembles that in Wright more closely than the facts 

of McCall, and held that the dual-capacity doctrine allowed Williamson’s tort suit to proceed, 

despite his FECA coverage. See Williamson, 2013 WL 4785689, at *3–6. The court recognized, 

however, that Wright’s analysis conflicts with that employed by most courts, which “have either 

rejected the [dual-capacity] doctrine or found it inapplicable.” Id. at *5. 

After a bench trial, the district court concluded that the VA was negligent in failing to 

diagnose Williamson’s fracture on December 4, 2009, see Williamson v. United States, 184 F. 

Supp. 3d 523, 530 (E.D. Ky. 2016); in failing to prescribe non-weight-bearing treatment in 

January 2010, id. at 532; and in performing the April 6, 2010 surgery, id.1 The Government now 

appeals the district court’s decision to allow the FTCA suit to continue. 

The plain text of FECA’s exclusive-remedy provision precludes Williamson’s FTCA 

suit. FECA is the federal government’s workers’ compensation scheme. Wright, 717 F.2d at 

256. Like most such statutes, FECA creates a quid pro quo—federal employees receive 

compensation for work-related injuries without having to prove fault, and in exchange, they lose 

the right to sue their government employer in tort. McCall, 901 F.2d at 550 (citing Lockheed 

Aircraft Corp. v. United States, 460 U.S. 190, 194 (1983)). The statute’s exclusive-remedy 

provision reads: 

 1

Before trial, the district court ordered that Williamson’s damages, if any, would be offset by the value of 

the benefits he had already received from the United States under TRICARE and FECA. Williamson v. United 

States, No. 5:12-cv-334-JMH-REW, 2015 WL 3734153, at *4 (E.D. Ky. June 15, 2015). The court ended up 

awarding Williamson $108,529.64 in medical expenses, $129,405.91 in past lost wages, and $120,000 for pain and 

suffering. Williamson, 184 F. Supp. 3d at 534. After a deduction of $133,601.16 based on Williamson’s TRICARE 

and FECA benefits, the total damage award was $224,334.39. Id. In his cross-appeal, Williamson argues that the 

court should not have included the $19,974.19 scheduled award or temporary disability payments from July 2012 to 

October 2012 in the damages offset, as those benefits were not duplicated in his damage award. However, because 

FECA precludes Williamson from receiving any tort damages, we do not reach this issue. 
Nos. 16-5979/6105 Williamson v. United States Page 5

The liability of the United States or an instrumentality thereof under this 

subchapter or any extension thereof with respect to the injury or death of an 

employee is exclusive and instead of all other liability of the United States or the 

instrumentality to the employee . . . because of the injury or death . . . under a 

Federal tort liability statute. 

5 U.S.C. § 8116(c). Here, the Secretary of Labor concluded that Williamson’s foot fracture was 

work related and subject to FECA coverage, and a federal court may not second-guess that 

determination, see 5 U.S.C. § 8128(b); Wright, 717 F.2d at 257. Thus, under § 8116(c), the 

United States is immune from any further liability arising “because of” Williamson’s foot injury. 

As a fundamental tort principle, injury caused by medical malpractice in the treatment of a 

previous, negligently caused injury is proximately caused by—and therefore occurs “because 

of”—the original underlying negligence. See, e.g., Restatement (Second) of Torts § 457 cmt. a 

(Am. Law Inst. 1965). As Learned Hand explained, the common-law negligence rule is that “the 

initial wrong is the cause of all that follows, even when there has intervened a succeeding 

negligent act that produced the aggravation.” Balancio v. United States, 267 F.2d 135, 137 

(2d Cir. 1959). Applying that principle, the VA’s negligence occurred because of Williamson’s 

workplace injury and therefore, under FECA’s exclusive-remedy provision, cannot subject the 

United States to liability. 

 Our alternative reliance on the dual-capacity doctrine in Wright v. United States does not 

compel a different result. Wright involved a secretary at a VA hospital. While at work, the 

secretary suffered a ruptured tubal pregnancy, which the VA hospital treated her for, including 

putting her on a respirator. After she was discharged, the secretary sued the United States under 

the FTCA, alleging medical malpractice in the VA’s application and operation of the respirator. 

In response, the Government argued that, because the secretary’s initial injury occurred at work, 

FECA provided her only redress. We held that the secretary was not entitled to FECA coverage 

for either the pregnancy-related injury or her throat injury. See Wright, 717 F.2d at 258. 

We reasoned that “[n]either the ruptured tubal pregnancy nor the throat injuries were sustained 

while [the secretary] was performing her” work-related duties. Id. Thus, there was no 

substantial question of FECA coverage to bar the tort suit. Id. Then, we went on to reason in the 

alternative that “even if [her] pregnancy had been compensable under the FECA, the present 

action would not be barred.” Id. at 259. We relied on the dual-capacity doctrine: “The dual 
Nos. 16-5979/6105 Williamson v. United States Page 6

capacity doctrine merely allows the employee to sue his employer where the employer-employee 

relationship does not exist because the employer is acting in a second persona unrelated to his 

status as employer.” Id. When applying the doctrine to the facts of the case, we recognized that 

the federal government was acting as the secretary’s doctor, not her employer, when it 

negligently treated her. Id. at 260. Thus, we concluded that “FECA would not prevent [her] 

from bringing an action for malpractice.” Id. 

Viewing Wright’s alternative reasoning in isolation, the same logic might apply here to 

allow Williamson’s tort suit to proceed. But in McCall we limited Wright to its primary holding, 

and effectively abandoned the dual-capacity doctrine as unnecessary to our decision in Wright. 

McCall involved a civilian employee who worked for the federal government as a contract 

specialist on an Air Force base. The base hospital treated the employee after she fell and 

fractured her hip at work. After receiving FECA benefits as a result of the injury, the employee 

sued the United States under the FTCA for medical malpractice during the military hospital’s 

treatment of her hip, which aggravated the injury. We held that the employee’s FTCA suit was 

barred, because FECA provided the exclusive remedy for her initial, work-related injury and the 

“additional injuries caused by negligent treatment of the first.” McCall, 901 F.2d at 550. 

We rejected the employee’s reliance on the dual-capacity doctrine: 

Wright, we believe, is distinguishable. In that case, the plaintiff was injured while 

at work, but her injury . . . was not work-related. . . . Another distinguishing 

factor is that Wright’s primary malpractice complaint was that improper use of a 

respirator damaged her trachea, an injury quite distinct from the one that brought 

her to the hospital in the first place. . . . McCall’s case is plainly different from 

the facts in Wright . . . . McCall’s initial injury was clearly suffered in the 

performance of her duties. The alleged malpractice injury was closely related to 

the initial injury. This case also differs from Wright in that there has been found 

to be FECA coverage involved. 

Id. at 551. 

Viewed solely through the lens of the dual-capacity doctrine, the outcomes in Wright and 

McCall appear to contradict one another. If the secretary in Wright could sue the United States 

in tort when the Government was acting as her doctor, regardless of FECA coverage, why should 

the employee in McCall be barred from suing the United States for its negligence in treating her 
Nos. 16-5979/6105 Williamson v. United States Page 7

FECA-covered injury? This inconsistency arises from the fact that we did not rely on the dualcapacity portion of Wright’s reasoning to reach our decision in McCall. Instead, our reasoning in 

McCall reflects Wright’s primary holding, under which, because the secretary did not sustain her 

initial injury or her malpractice-induced trachea injury while performing her duties as a federal 

employee, her tort suit did not pose a substantial question of FECA coverage, see Wright, 

717 F.2d at 258. In turn, because there was no substantial question of FECA coverage, FECA’s 

exclusive-remedy provision did not bar the secretary’s tort suit. Id. We applied the same line of 

reasoning in McCall to reach the opposite result: because the employee did sustain her initial 

injury while performing her duties as a federal employee, and because the following, 

malpractice-induced injury was “closely related” to the first, the employee’s tort suit posed a 

substantial question of FECA coverage. See McCall, 901 F.2d at 551. Thus, FECA’s exclusiveremedy provision barred the employee’s tort suit. Id. at 551–52. By using Wright’s primary 

holding and declining to rely on the dual-capacity doctrine, we effectively held in McCall that 

Wright is correct for its primary holding and not because of its alternative reasoning.2 McCall

therefore significantly undermines the precedential value of Wright’s alternative holding, and 

thus the entire dual-capacity doctrine, as it applies to FECA. Thus, Williamson cannot now rely 

on the dual-capacity doctrine to overcome the plain terms of FECA’s exclusive-remedy 

provision, which precludes his FTCA suit. FECA is Williamson’s sole redress for his foot 

fracture and the VA’s negligence in diagnosing and treating the fracture. 

Every other court of appeals to have examined the issue has similarly held that the dualcapacity doctrine does not create an exception to FECA’s exclusive-remedy provision. See 

Spinelli v. Goss, 446 F.3d 159, 161 (D.C. Cir. 2006); Elman v. United States, 173 F.3d 486, 492 

(3d Cir. 1999); Votteler v. United States, 904 F.2d 128, 130–31 (2d Cir. 1990); Wilder v. United 

States, 873 F.2d 285, 288–89 (11th Cir. 1989) (per curiam); Vilanova v. United States, 851 F.2d 

1, 7 n.24 (1st Cir. 1988); see also Lance v. United States, 70 F.3d 1093, 1095 (9th Cir. 1995) (per 

curiam); Balancio, 267 F.2d 135. 

 2

This analysis comports with how we interpreted McCall’s treatment of Wright in Saltsman v. United 

States, 104 F.3d 787 (6th Cir. 1997): “The dual-capacity doctrine appears merely to represent a rewording of the 

standard inquiry under FECA of whether an employee suffered his injuries ‘while in the performance of his duty.’” 

Id. at 791 n.7 (citing McCall, 901 F.2d at 551). 
Nos. 16-5979/6105 Williamson v. United States Page 8

The judgment of the district court is reversed, and the case is remanded for proceedings 

consistent with this opinion.