United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

S.M., Appellant 

and 

DEPARTMENT OF TRANSPORTATION, 

TRANSPORTATION SECURITY 

ADMINISTRATION, Lihue, HI, Employer 

__________________________________________ 

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Docket No. 14-107 

Issued: March 27, 2014 

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

RICHARD J. DASCHBACH, Chief Judge 

COLLEEN DUFFY KIKO, Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On October 21, 2013 appellant filed a timely appeal of the October 2, 2013 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 merit decision of the case. 

ISSUE 

The issue is whether appellant has met her burden of proof to establish an occupational 

disease in the performance of duty. 

FACTUAL HISTORY 

On August 12, 2013 appellant then a 38-year-old transportation security officer filed a 

Form CA-2, occupational disease claim alleging that she developed heat stroke while working at 

 

 1 5 U.S.C. §§ 8101-8193. 
2 

a checkpoint while in the performance of duty. She became aware of her condition and realized 

it was causally related to her employment on July 30, 2013. Appellant did not stop work. 

On August 19, 2013 OWCP advised appellant of the type of evidence needed to establish 

her claim. It particularly requested that she submit a physician’s reasoned opinion addressing the 

relationship of her claimed condition and specific work factors. 

The employing establishment submitted an August 7, 2013 incident report from 

Crystal M. DeRego, supervisory transportation security officer, who noted that on August 7, 

2013 appellant reported that she felt ill and was hot and had a headache. Ms. DeRego noted 

appellant reported feeling ill one week prior with the same symptoms, refused medical attention 

but rested in the break room for two hours. Appellant refused to go home because she did not 

have enough leave and indicated that she would file a claim for compensation. Ms. DeRego 

noted that appellant reported to the break room and then was taken to the hospital for treatment. 

In a letter of contravention dated August 30, 2013, the employing establishment asserted that 

appellant had not established her claim. 

In a statement dated September 6, 2013, appellant indicated that on July 30, 2013 it was 

extremely hot and humid as a tropical storm had passed through the area. She noted working in 

the airport main checkpoint and noticed the temperature was 86.1. Appellant noted that she was 

scheduled to be an x-ray operator in a lane that was close to a wall without air circulation. She 

advised that by 1:55 p.m. she was overheated and developed heat stroke and her heart started to 

race, she began to pant, she became nauseous, weak and dizzy and requested to sit in the break 

room. Appellant reported the symptoms of weakness, dizziness, fatigue, headaches, nausea 

lasted for three weeks. 

Appellant submitted a Hawaii emergency medical services (EMS) report prepared by an 

unidentifiable health care provider on August 1, 2013 which noted her complaints of a frontal 

headache for two days. She reported not feeling well with symptoms of fever and chills. 

Appellant was diagnosed with frontal headache, possible migraine versus rebound headaches and 

anxiety. 

Appellant was treated by Dr. Erik J. Schumacher, Board-certified in emergency 

medicine, on August 1, 2013, for a headache present for two days which developed at work. She 

reported resting and within a couple of hours the headache resolved. Appellant returned to work 

and stated that the headache and nausea returned and attributed the symptoms to an extremely 

hot day. Dr. Schumacher noted normal examination findings. He diagnosed acute headache and 

discharged appellant from his care in satisfactory condition. Appellant was provided discharge 

instructions for headaches. 

Appellant was treated by Dr. Spencer Smith, Board-certified in emergency medicine, on 

August 7, 2013, for headache, dizziness and nausea. She reported that she “overdid it” at work 

last week and was treated in the emergency room for heat stroke. Appellant indicated that she 

was discharged from the emergency room in stable condition and attempted to return to work but 

continued to feel dizzy, nauseated with a persistent headache. Dr. Smith noted normal 

examination findings. He diagnosed headache, dizziness and nausea and discharged appellant. 

Dr. Smith noted that she was given valium for the dizziness but she continued to have lingering 
3 

symptoms. He noted that appellant requested a lengthy release from work to rest. Dr. Smith 

provided her with discharge instructions for self-care for headaches. In a medical excuse form 

dated August 7, 2013, he treated appellant for an illness and diagnosed “medical” and stated that 

she could not work from August 8 to 17, 2013. Appellant submitted laboratory reports dated 

August 7, 2013 and discharge instructions for self-care for headaches. 

In an October 2, 2013 decision, OWCP denied the claim on the grounds that the medical 

evidence was insufficient to establish that appellant’s claimed conditions were casually related to 

work events. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA has the burden of proof to establish the 

essential elements of his or her claim. When an employee claims that he or she sustained an 

injury in the performance of duty, he or she must submit sufficient evidence to establish that he 

or she experienced a specific event, incident or exposure occurring at the time, place and in the 

manner alleged. Appellant must also establish that such event, incident or exposure caused an 

injury.2

 

To establish that an injury was sustained in the performance of duty in an occupational 

disease claim, a claimant must submit the following: (1) medical evidence establishing the 

presence or existence of the disease or condition for which compensation is claimed; (2) factual 

statement identifying employment factors alleged to have caused or contributed to the presence 

or occurrence of the disease or condition; and (3) medical evidence establishing that the 

employment factors identified by the claimant were the proximate cause of the condition for 

which compensation is claimed or, stated differently, medical evidence establishing that the 

diagnosed condition is causally related to the employment factors identified by claimant. The 

medical evidence required to establish causal relationship is generally rationalized medical 

opinion evidence. Rationalized medical opinion evidence is medical evidence which includes a 

physician’s rationalized opinion on the issue of whether there is a causal relationship between the 

claimant’s diagnosed condition and the implicated employment factors. The opinion of the 

physician must be based on a complete factual and medical background of the claimant, 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 the specific employment factors 

identified by the claimant.3

ANALYSIS 

It is not disputed that appellant’s duties as transportation security officer included 

prolonged standing and being exposed to temperatures of approximately 85 degrees while 

performing her duties. It is also not disputed that she has been diagnosed with acute headache, 

dizziness and nausea. However, appellant has not submitted sufficient medical evidence to 

 

2 See Walter D. Morehead, 31 ECAB 188, 194 (1979) (occupational disease or illness); Max Haber, 19 ECAB 

243, 247 (1967) (traumatic injury). See generally John J. Carlone, 41 ECAB 354 (1989); Elaine Pendleton, 40 

ECAB 1143 (1989). 

3 Solomon Polen, 51 ECAB 341 (2000). 
4 

establish that any of these conditions are causally related to specific employment factors or 

conditions. 

Appellant submitted an August 1, 2013 report from Dr. Schumacher who, had treated her 

for a headache two days prior at work. She reported her headache resolved after rest but, upon 

returning to work, the headache and nausea returned. Appellant attributed her symptoms to an 

extremely hot day. Dr. Schumacher noted normal findings on examination and diagnosed acute 

headache and discharged her from his care in satisfactory condition. He appears to be repeating 

the history of injury as reported by appellant without providing own opinion regarding whether 

her condition was work related. To the extent that Dr. Schumacher is providing his own opinion, 

he did not provide a rationalized opinion regarding the causal relationship between her 

headaches, dizziness and nausea and the factors of employment believed to have caused or 

contributed to such condition.4

 Therefore, this report is insufficient to meet appellant’s burden of 

proof. 

In an August 7, 2013 report, Dr. Smith treated appellant for headache, dizziness and 

nausea. Appellant reported that she overdid it at work and was treated in the emergency room 

for heat stroke. She indicated that she was discharged from the emergency room in stable 

condition and attempted to return to work but continued to feel dizzy, nauseated with a persistent 

headache. Dr. Smith noted an essentially normal examination and diagnosed headache, dizziness 

and nausea and discharged appellant. As noted above, he appears to be repeating the history of 

injury as reported by her without providing his own opinion regarding whether her condition was 

work related. Even if this could be construed as an opinion supporting causal relationship, 

Dr. Smith did not provide medical rationale explaining that particular work factors caused or 

aggravated appellant’s headaches, dizziness and nausea.5 Therefore, this report is insufficient to 

meet appellant’s burden of proof. Also submitted was an August 7, 2013 medical excuse form 

from Dr. Smith who treated her for an illness and diagnosed “medical” and stated that appellant 

could not work from August 8 to 17, 2013. However, this note is of limited probative value as it 

does not address whether employment factors caused appellant’s disability. Therefore this note 

in insufficient to meet her burden of proof. 

Other medical evidence submitted by appellant including laboratory reports and 

discharge instructions for a headache are also insufficient as such evidence does not provide a 

physician’s opinion on the causal relationship between her job and her diagnosed headaches, 

dizziness and nausea. Consequently, the medical evidence is not sufficient to meet her burden of 

proof. 

Appellant also submitted an August 1, 2013 Hawaii EMS report prepared by an 

unidentifiable health care provider which noted her complaints of a frontal headache and 

diagnosed frontal headache, possible migraine versus rebound headaches and anxiety. However, 

this is of no probative medical weight as there is no evidence that this document is from a 

physician. The Board has held that a medical report may not be considered as probative medical 

 4 Jimmie H. Duckett, 52 ECAB 332 (2001); Franklin D. Haislah, 52 ECAB 457 (2001) (medical reports not 

containing rationale on causal relationship are entitled to little probative value). 

5 See supra note 5. 
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evidence if there is no indication that the person completing the report qualifies as a physician as 

defined in 5 U.S.C. § 8101(2).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 did not meet her burden of proof to establish that her 

claimed conditions were causally related to her employment.7

 

ORDER 

IT IS HEREBY ORDERED THAT the October 2, 2013 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: March 27, 2014 

Washington, DC 

 

 Richard J. Daschbach, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board 

 6 C.B., Docket No. 09-2027 (issued May 12, 2010). 

7

 With her request for an appeal, appellant submitted additional evidence. However, the Board may not consider 

new evidence on appeal; see 20 C.F.R. § 501.2(c).