United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

D.I., Appellant 

and 

DEPARTMENT OF THE INTERIOR, BUREAU 

OF LAND MANAGEMENT, Phoenix, AZ, 

Employer 

__________________________________________ 

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Docket No. 15-468 

Issued: July 23, 2015 

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

COLLEEN DUFFY KIKO, Judge 

ALEC J. KOROMILAS, Alternate Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On December 22, 2014 appellant filed a timely appeal of a November 7, 2014 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.2

ISSUE 

The issue is whether appellant has met his burden of proof to establish that he sustained a 

traumatic injury in the performance of duty. 

 

 1 5 U.S.C. §§ 8101-8193. 

2

 Appellant filed a timely request for oral argument. By order dated May 5, 2015, the Board denied his request as 

his arguments could be adequately addressed in a decision based on a review of the case record. Order Denying 

Request for Oral Argument, Docket No. 15-468 (issued May 5, 2015). 
2

FACTUAL HISTORY 

On May 21, 2013 appellant then a 45-year-old mission support technician, filed a Form 

CA-1, traumatic injury claim alleging that on April 10, 2013, he was struck by the handle of a 

malfunctioning plate tamper and injured his upper left thigh. The field manager, Rem Hawes, 

noted on the Form CA-1 that appellant was injured in the performance of duty. Appellant did 

not stop work. 

In an October 23, 2013 telephone memorandum, appellant inquired about the status of his 

claim and noted that he had surgery. 

By letter dated October 23, 2013, OWCP advised appellant that his claim was originally 

received as a simple, uncontroverted case which resulted in minimal or no time loss from work. 

It indicated that his claim was administratively handled to allow medical payments up to 

$1,500.00; however, the merits of the claim had not been formally adjudicated. OWCP advised 

that, because appellant requested authorization for surgery, his claim would be formally 

adjudicated. It requested that he submit additional information including a comprehensive 

medical report from his treating physician which included a reasoned explanation as to how the 

specific work factors or incidents identified by appellant had contributed to his claimed upper 

left thigh injury. 

Appellant submitted a statement dated November 6, 2013 and noted that on April 10, 

2013 he was injured while operating a walk-behind trencher. He noted pushing up on the throttle 

and pulling down to level the machine when he was struck in the thigh and groin area by the 

handle. Appellant reported that his condition had not improved and that he had increasing pain 

in his neck, shoulder, and upper back and may require another arthroscopy for his groin injury. 

Appellant was treated by Dr. Kashif Alvi, a Board-certified urologist, from April 11, 

2011 to February 16, 2013 for left testicle pain and infertility. On April 11, 2011 he underwent 

testicular imaging which revealed a large caliber left-sided varicoceles, prominent cysts at the 

head of the left epididymis and prominent tubular ectasia of the left testicle. Dr. Alvi noted that 

appellant had undergone a vasectomy and later reversal of the vasectomy in the 1990’s. 

Appellant was treated by Dr. Sheldon Marks, a Board-certified urologist, who on 

August 16, 2013 performed a bilateral multilayer microdot microsurgical vasovasostomy for 

pain, excision of scarred vas, and clips. Dr. Marks diagnosed postvasectomy pain syndrome, 

significant, chronic, refractory to conservative therapy, dense scarring, bilateral metals clips, and 

right vasal fluid under pressure. On November 7, 2013 he noted that appellant underwent an 

intrascrotal exploration and redo microsurgical vasectomy reversal for treatment of persistent, 

refractory inguinal and genital pain which appellant reported began following trauma to his 

groin. Dr. Marks noted significant, extensive intrascrotal scarring and inflammation along and 

around the spermatic cord and around the testicle, which seemed much more than that normally 

found for this type of surgery. He opined that the extensive scarring could have been from 

bleeding and trauma as described by appellant. Appellant submitted a job description for a 

materials handler. 
3

The employing establishment submitted a statement from Patrick Putnam, the associate 

district manager, who noted that on April 10 2013 appellant was operating a walk-behind 

trencher which malfunctioned and struck him in the upper thigh/groin area. Mr. Putnam noted 

that appellant did not mention the injury immediately but when he did he was instructed to file a 

claim. He concurred that the incident took place on the job. 

In a December 13, 2013 decision, OWCP accepted that the evidence established that the 

incident occurred as alleged but denied the claim as appellant had failed to submit medical 

evidence containing a diagnosis causally related to the April 10, 2013 incident. 

On January 13, 2014 appellant requested an oral hearing which was held on 

September 2, 2014. He submitted emergency room notes from May 15, 2013 where he was 

treated by Dr. Meera Chopra, an osteopath, for a soft tissue injury to left hip and inguinal area. 

Appellant reported an onset of symptoms three days prior when he hit his left hip on a truck at 

work. He also reported left anterior hip pain since he was hit by the handle of a paver at work. 

Appellant related that his problem was job related. Findings upon physical examination revealed 

the skin over the left hip and iliac crest was intact without visible abrasion or laceration, there 

was no active bleeding and the neurovascular examination was intact. Dr. Chopra diagnosed left 

thigh injury after appellant was hit by a handle of a paver at work. He noted May 15, 2013 xrays of the hip and pelvis revealed no radiographic evidence of an acute fracture.3

 

In an addendum dated October 24, 2013, a physician assistant indicated that appellant 

contacted the office and asserted that his leg injury was related to an allergic reaction to onions at 

Taco Bell. The physician assistant noted reviewing the chart and advised that appellant had not 

previously reported an allergic reaction to the physician or nurses. 

Appellant submitted discharge instructions from a physician assistant dated August 24, 

2013 who diagnosed testicular masses. Also submitted was an information sheet on the 

condition of rhabdomyolysis. 

In a decision dated November 7, 2014, an OWCP hearing representative affirmed the 

December 13, 2013 decision, as modified. She denied that the claimed work event on April 10, 

2013 occurred as alleged. The hearing representative noted that appellant had waited over 30 

days to file his compensation claim and to seek medical attention for the claimed work injury. 

She was inconsistent with the severity of the injury claimed. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA has the burden of establishing the essential 

elements of his or her claim including the fact that the individual is an employee of the United 

States within the meaning of FECA, that the claim was filed within the applicable time limitation 

of FECA, that an injury was sustained in the performance of duty as alleged and that any 

disability and/or specific condition for which compensation is claimed is causally related to the 

 3

 A March 15, 2013 x-ray reports for the pelvis and the left hip accompanied the emergency room documents. No 

acute findings were noted on the pelvis x-ray and a radiologically intact hip was noted on the left hip. 
4

employment injury. 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.4

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. First, the employee must 

submit sufficient evidence to establish that he actually experienced the employment incident at 

the time, place, and in the manner alleged. Second, the employee must submit medical evidence 

to establish that the employment incident caused a personal injury.5

An employee’s statement that an injury occurred at a given time and in a given manner is 

of great probative value and will stand unless refuted by strong or persuasive evidence.6 

Moreover, an injury does not have to be confirmed by eyewitnesses. The employee’s statement, 

however, must be consistent with the surrounding facts and circumstances and her subsequent 

course of action. An employee has not met his or her burden in establishing the occurrence of an 

injury when there are such inconsistencies in the evidence as to cast serious doubt upon the 

validity of the claim. Circumstances such as late notification of injury, lack of confirmation of 

injury, continuing to work without apparent difficulty following the alleged injury, and failure to 

obtain medical treatment may, if otherwise unexplained, cast doubt on an employee’s statement 

in determining whether a prima facie case has been established.7

Causal relationship is a medical issue and the evidence generally required to establish 

causal relationship is rationalized medical opinion evidence. Rationalized medical opinion 

evidence is generally required to establish causal relationship. The opinion of the physician must 

be based on a complete factual and medical background, 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.8

ANALYSIS 

OWCP denied appellant’s claim as the claimed incident, being struck by the handle of a 

malfunctioning plate tamper on April 10, 2013, did not occur as alleged. The Board finds to the 

contrary that the April 10, 2013 incident with the plate tamper did occur as alleged by appellant. 

On the Form CA-1 and in a narrative statement appellant described his duties. The employing 

establishment did not dispute the accuracy of appellant’s description of the work incident. The 

field manager, Mr. Hawes, noted on the Form CA-1 that appellant was injured in the 

performance of duty. Similarly, a statement from Mr. Putnam, the associate district manager, 

noted that on April 10, 2013 appellant was operating a walk behind trencher which 

 4 Gary J. Watling, 52 ECAB 357 (2001). 

5

 T.H., 59 ECAB 388 (2008). 

6 R.T., Docket No. 08-408 (issued December 16, 2008); Gregory J. Reser, 57 ECAB 277 (2005). 

7 Betty J. Smith, 54 ECAB 174 (2002). 

8 I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 ECAB 345 (1989). 
5

malfunctioned and struck him in the upper thigh/groin area. He concurred that the incident took 

place on the job. The hearing representative found that the incident did not occur because 

appellant had waited more than 30 days to file the claim and that he had other injuries in the 

same part of the body. 

The mere fact that appellant had prior medical problems affecting the same part of the 

body is not evidence that he did not have a new separate work injury to the same area.9

 While 

appellant did not immediately file the claim, this is not the only criteria to be considered in 

determining whether a claimant has established that the incident occurred. Here, two managers 

agreed that the claimed incident occurred. In view of this evidence, the Board finds that 

appellant established that the April 10, 2013 employment incident occurred as alleged. 

The Board finds, however, that the medical evidence is insufficient to establish that his 

diagnosed condition was caused or aggravated by this incident. On October 23, 2013 OWCP 

advised appellant of the type of medical evidence needed to establish his claim. However, 

appellant did not submit medical evidence to establish that any of these conditions are causally 

related to his incident. 

 Appellant was treated by Dr. Marks on August 16, 2013 who performed a bilateral 

microsurgical vasovasostomy and diagnosed postvasectomy pain syndrome, with dense scarring, 

bilateral metal clips and right vasal fluid under pressure. On November 7, 2013 Dr. Marks noted 

that appellant underwent an intrascrotal exploration and microsurgical vasectomy reversal for 

treatment of persistent, inguinal, and genital pain. Appellant reported that this pain began 

following trauma to his groin. He noted significant, extensive intrascrotal scarring and 

inflammation around the spermatic cord and testicle, and opined that the extensive scarring could 

have been from bleeding and trauma as described by appellant. The Board notes that this report 

provides some support for causal relationship but is insufficient to establish that the claimed left 

thigh and groin injury was causally related to his employment duties. In his report, Dr. Marks 

opined only that extensive scarring “could have” been caused by trauma described by appellant. 

This report provides only speculative support for causal relationship because of the qualifier that 

appellant’s employment “could have” caused his condition. Dr. Marks provided no medical 

reasoning to support his opinion on causal relationship. Therefore, this report is insufficient to 

meet appellant’s burden of proof.10

 Appellant was treated by Dr. Chopra on May 15, 2013 for a soft tissue injury to left hip 

and inguinal area. Dr. Chopra reported an onset of symptoms three days prior when appellant hit 

his left hip on a truck at work. He noted x-rays of the pelvis and hip were negative. Dr. Chopra 

diagnosed left thigh injury and anterior hip pain occurring after appellant was hit by a handle of a 

paver at work. He also noted that appellant had sustained another recent injury to his hip when 

he hit a bumper at work. Dr. Chopra’s report attributed appellant’s condition, at least in part, to 

 9 See Thomas J. O’Donnell, 3 ECAB 179, 183 (1950) (it matters not what the state or condition of the health of 

the employee might be; if the conditions of employment constitute the precipitating cause of disability, such 

disability is compensable as having resulted from accidental injury arising out of the employment). 

10 Medical opinions that are speculative or equivocal in character are of diminished probative value. D.D., 57 

ECAB 734 (2006). 
6

an unrelated incident when appellant hit his hip on the bumper of his automobile. He failed to 

provide a rationalized opinion regarding the causal relationship between appellant’s left thigh 

and hip injury and the factors of employment.11 Therefore, this report is of limited probative 

value and insufficient to meet appellant’s burden of proof. 

Appellant submitted reports from Dr. Alvi dated April 11, 2011 to February 16, 2013 

who diagnosed large caliber left-sided varicoceles, prominent cysts at the head of the left 

epididymis and prominent tubular ectasia of the left testicle. However, these reports are not 

persuasive because they predate the time of the claimed incident of April 10, 2013. 

Appellant submitted discharge instructions from a physician assistant dated August 24, 

2013 and an addendum note dated October 24, 2013. However, the Board has held that 

treatment notes signed by a physician assistant are not considered medical evidence as this 

provider is not a physician under FECA.12 

The remainder of the medical evidence, including diagnostic test reports, fail to provide 

an opinion on the causal relationship between appellant’s job and his diagnosed left thigh, hip, 

and groin injury. For this reason, this evidence is not sufficient to meet appellant’s burden of 

proof.13 

On appeal appellant asserted that OWCP had improperly denied his claim and believed 

he submitted sufficient evidence to establish that on April 10, 2013 he sustained a left thigh and 

groin injury. For the reasons explained, the medical evidence does not establish that his 

diagnosed conditions are causally related to his employment. 

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 his burden of proof to establish that his 

claimed conditions were causally related to his employment. 

 11 See 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). 

12 See David P. Sawchuk, 57 ECAB 316 (2006) (lay individuals such as physician’s assistants, nurses and 

physical therapists are not competent to render a medical opinion under FECA); 5 U.S.C. § 8101(2) (this subsection 

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). 

13 A.D., 58 ECAB 149 (2006) (medical evidence which does not offer any opinion regarding the cause of an 

employee’s condition is of limited probative value on the issue of causal relationship). 
7

ORDER 

IT IS HEREBY ORDERED THAT the November 7, 2014 decision of the Office of 

Workers’ Compensation Programs is affirmed, as modified. 

Issued: July 23, 2015 

Washington, DC 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board