United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

D.T., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

St. Louis, MO, Employer 

__________________________________________ 

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Docket No. 14-2024 

Issued: June 24, 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 September 23, 2014 appellant filed a timely appeal from a May 13, 2014 merit 

decision and a July 15, 2014 nonmerit 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

 

ISSUES 

The issues are: (1) whether appellant met her burden of proof to establish a right wrist 

injury in the performance of duty on February 4, 2014; and (2) whether OWCP abused its 

 1

 5 U.S.C. § 8101 et seq.

2

 The Board notes that appellant submitted additional evidence after OWCP rendered its July 15, 2014 decision. 

The Board’s jurisdiction is limited to reviewing the evidence that was before OWCP at the time of its final decision. 

Therefore, this additional evidence cannot be considered by the Board. 20 C.F.R. § 501.2(c)(1); Dennis E. Maddy, 

47 ECAB 259 (1995); James C. Campbell, 5 ECAB 35, 36 n.2 (1952). Appellant may submit this evidence to 

OWCP, together with a formal request for reconsideration, pursuant to 5 U.S.C. § 8128(a) and 20 C.F.R. 

§ 10.606(b)(2). 
2

discretion in denying appellant’s request for a review of the written record as untimely filed, 

under 5 U.S.C. § 8124(b)(1). 

FACTUAL HISTORY 

On February 4, 2014 appellant, then a 57-year-old clerk, filed a traumatic injury claim 

(Form CA-1) alleging that on that same date she sustained a right wrist/hand injury when she 

placed her foot on top of a trashcan to tie her shoe, lost her balance, and fell onto her right wrist. 

A February 6, 2014 witness statement from Shawn Jones, a fellow coworker, stated that he heard 

the trashcan wobble and saw appellant fall to the floor and land on her back. Appellant notified 

her supervisor and first sought medical treatment on the date of incident, February 4, 2014. 

The employing establishment issued appellant a properly completed Form CA-16, 

authorization for examination, dated February 4, 2014, authorizing medical treatment related to 

the February 4, 2014 injury. The description of injury was reported as sprain/break of the right 

wrist/hand. The employing establishment did not dispute that appellant’s claimed right 

hand/wrist injury was due to the February 4, 2014 employment incident. 

In the February 4, 2014 emergency room (ER) report, Dr. Terry Thrasher, a Doctor of 

Osteopathic Medicine, reported that appellant complained of right wrist pain which began at 

work on that same date. He noted that appellant slipped on ice/snow and landed on her right 

wrist. Physical examination revealed pain and swelling. A February 4, 2014 x-ray of the right 

wrist revealed impacted fracture of the radius with intra-articular extension and soft tissue 

swelling. Dr. Thrasher diagnosed right wrist radius fracture and provided appellant with a splint. 

In the attending physician’s report accompanying the Form CA-16, Dr. Thrasher 

diagnosed right radius fracture. The question about whether the injury was caused by work was 

left unanswered. Dr. Thrasher restricted use of the upper right extremity and referred appellant 

for orthopedic evaluation. In a February 4, 2014 duty status report (Form CA-17), appellant’s 

supervisor indicated that appellant lost her balance, fell, and broke her right hand on 

February 4, 2014. Dr. Thrasher diagnosed right wrist fracture and answered “Yes” when asked if 

the diagnosis was due to injury. He provided appellant with work restrictions. 

Dr. Thomas R. Turnbaugh, a Board-certified orthopedic surgeon, in a February 6, 2014 

report, noted that on February 4, 2014 appellant had tripped and fallen at work, causing her to 

land on her right wrist. He reviewed diagnostic testing and provided findings on physical 

examination and diagnosed displaced intra-articular fracture of the right distal radius and 

recommended surgery following further testing. 

In a February 7, 2014 diagnostic report, Dr. D. Kent McNutt, a Doctor of Osteopathic 

Medicine, reported that a computerized tomography (CT) scan of the right wrist revealed 

comminuted intra-articular fracture of the distal radius. 

Dr. Turnbaugh on February 9, 2014 performed an open reduction of comminuted intraarticular fracture, right distal radius with internal fixation using two dorsal plates. 

In medical reports dated February 13 to March 6, 2014, Dr. Turnbaugh diagnosed status 

post open reduction of comminuted intra-articular fracture of the right distal radius with internal 
3

fixation with good restoration of the articular surface. On March 6, 2014 appellant’s cast and 

sutures were removed. 

By letter dated April 15, 2014, OWCP informed appellant that additional evidence was 

needed to support her claim and was directed to submit it to OWCP within 30 days. 

In support of her claim, appellant submitted a February 9, 2014 anesthesia record and a 

March 20, 2014 physical therapy note. 

By decision dated May 13, 2014, OWCP denied appellant’s claim finding that the 

medical evidence of record failed to establish that her right wrist fracture was causally related to 

the accepted February 4, 2014 employment incident. It noted that the Form CA-16 did not relate 

her injury to the work incident and Dr. Thrasher left the box unanswered when asked if the 

condition found was caused or aggravated by the employment activity described. 

On June 17, 2014 appellant requested review of the written record before the Branch of 

Hearings and Review. The request was received on June 20, 2014. 

In a May 22, 2014 report, Dr. Turnbaugh diagnosed status post open reduction of 

comminuted intra-articular fracture of the right distal radius with internal fixation with good 

progression of recovery and improvement in motion. He further diagnosed deformity of the nail 

bed of the right thumb, thus far minimal. Appellant also submitted an April 26, 2014 Form CA17 and an April 26, 2014 physical therapy note indicating treatment on that date. 

By decision dated July 15, 2014, Branch of Hearings and Review denied appellant’s 

request for a review of the written record finding that her request was not made within 30 days of 

the May 13, 2014 OWCP decision. The Branch of Hearings and Review further determined that 

the issue in the case could equally well be addressed by requesting reconsideration from OWCP 

and submitting evidence not previously considered which established that the claimed medical 

condition was related to the established employment incident. 

LEGAL PRECEDENT -- ISSUE 1 

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

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

employment injury.3

 These are the essential elements of each and every compensation claim 

regardless of whether the claim is predicated on a traumatic injury or an occupational disease.4

In order to determine whether an employee actually sustained an injury in the 

performance of duty, OWCP begins with an analysis of whether fact of injury has been 

 3 Gary J. Watling, 52 ECAB 278 (2001); Elaine Pendleton, 40 ECAB 1143, 1154 (1989). 

4 Michael E. Smith, 50 ECAB 313 (1999). 
4

established. Generally, fact of injury consists of two components which must be considered in 

conjunction with one another. The first component to be established is that the employee 

actually experienced the employment incident which is alleged to have occurred.5 The second 

component is whether the employment incident caused a personal injury and generally can be 

established only by medical evidence. 

OWCP’s procedures recognize that a claim may be accepted without a medical report 

when the condition is a minor one which can be identified on visual inspection.6 In clear-cut 

traumatic injury claims, such as an obvious broken arm resulting from a fall, a physician’s 

affirmative statement is sufficient and no rationalized opinion on causal relationship is needed. 

In all other traumatic injury claims, a rationalized medical opinion supporting causal relationship 

is required.7

To establish a causal relationship between the condition, as well as any attendant 

disability claimed and the employment event or incident, the employee must submit rationalized 

medical opinion evidence supporting such a causal relationship.8

 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. This medical opinion must include an accurate history of the 

employee’s employment injury and must explain how the condition is related to the injury. The 

weight of medical evidence is determined by its reliability, its probative value, its convincing 

quality, the care of analysis manifested, and the medical rationale expressed in support of the 

physician’s opinion.9

ANALYSIS -- ISSUE 1 

Despite inconsistencies as to how the injury occurred, OWCP accepted that the 

February 4, 2014 employment incident occurred as alleged. The issue before the Board is 

whether appellant established that the incident caused her a right wrist fracture. The Board finds 

that she did not submit sufficient medical evidence to support that her right wrist fracture is 

causally related to the February 4, 2014 employment incident.10 

In ER reports dated February 4, 2014, Dr. Thrasher reported that appellant complained of 

right wrist pain which began at work on that same date, noting that appellant slipped on 

ice/snow. Upon review of diagnostic testing, he diagnosed right wrist radius fracture. 

 5 Elaine Pendleton, supra note 3. 

6

 Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.805.3 (January 2013). 

7 Id. 

8 See 20 C.F.R. § 10.110(a); John M. Tornello, 35 ECAB 234 (1983). 

9 James Mack, 43 ECAB 321 (1991). 

10 See Robert Broome, 55 ECAB 339 (2004). 
5

In clear-cut traumatic injury claims, such as a fall resulting in an obvious broken arm, a 

physician’s affirmative statement may be sufficient and no rationalized opinion on causal 

relationship is needed.11 While appellant sought immediate medical treatment on February 4, 

2014 and submitted contemporaneous hospital and diagnostic records of treatment indicating a 

right wrist fracture, Dr. Thrasher failed to provide an opinion regarding the cause of her injury, 

based upon an accurate history of injury. A physician’s report is entitled to little probative value 

if the history presented is inaccurate and incomplete.12 While Dr. Thrasher related a history of 

injury in his February 4, 2014 report that appellant had slipped on ice/snow and landed on her 

wrist, this history is not consistent with appellant’s allegations and her witness statement as to 

how the injury occurred. He submitted the February 4, 2014 Form CA-16 attending physician’s 

report but did not respond when asked if the injury was caused by the described employment 

activity. In this instance, Dr. Thrasher’s reports are insufficient to establish appellant’s claim as 

he failed to provide an affirmative statement, based upon an accurate history of injury, regarding 

the cause of appellant’s right wrist fracture. 

In reports dated February 6 to May 22, 2014, Dr. Turnbaugh reported that appellant 

tripped and fell at work on February 4, 2014, causing her to land on her right hand. He 

diagnosed displaced intra-articular fracture of the right distal radius and documented appellant’s 

treatment following her February 9, 2014 operation. Dr. Turnbaugh’s reports are of limited 

probative value as he merely related a history of injury but failed to state any opinion on the 

cause of appellant’s injury.13 In this regard, the Board also notes that Dr. Turnbaugh’s history of 

injury, that appellant tripped, fell and landed on her right hand is inconsistent with the history 

provided by appellant’s witness that the trashcan appellant had placed her foot on wobbled, 

appellant fell to the floor and landed on her back. 

The remaining medical evidence of record including physical therapy notes, x-rays, and 

test results, which do not contain an opinion as to the cause of appellant’s right wrist fracture, are 

of limited probative value.14 Any medical opinion evidence appellant may submit to support her 

claim should reflect a correct history and offer a medically sound explanation by the physician of 

how the specific employment incident, in particular physiologically, caused or aggravated her 

right wrist injury.15

Appellant’s honest belief that the February 4, 2014 employment incident caused her right 

wrist fracture is not in question. But that belief, however sincerely held, does not constitute the 

medical evidence necessary to establish causal relationship. In the instant case, the record lacks 

rationalized medical evidence establishing a causal relationship between the February 4, 2014 

employment incident and appellant’s injury. Thus, appellant has failed to meet her burden of 

proof. 

 11 Supra note 6. 

12 See James A. Wyrick, 31 ECAB 1805 (1980). 

13 S.E., Docket No. 08-2214 (issued May 6, 2009); C.B., Docket No. 09-2027 (issued May 12, 2010). 

14 Q.G., Docket No. 11-1514 (issued February 13, 2012). 

15 T.G., Docket No. 14-751 (issued October 20, 2014). 
6

The Board also notes that the employing establishment issued a Form CA-16 on 

February 4, 2014 authorizing medical treatment.16 The Board has held that when the employing 

establishment properly executes a Form CA-16 which authorizes medical treatment as a result of 

an employee’s claim for an employment-related injury, the Form CA-16 creates a contractual 

obligation, which does not involve the employee directly, to pay for the cost of the examination 

or treatment regardless of the action taken on the claim. The period for which treatment is 

authorized by a Form CA-16 is limited to 60 days from the date of issuance, unless terminated 

earlier by OWCP.17 Although OWCP denied appellant’s claim for an injury, it did not address 

whether she would be entitled to reimbursement of medical expenses pursuant to the Form CA16. Upon return of the case record, OWCP should further address this issue.18

LEGAL PRECEDENT -- ISSUE 2 

Section 8124(b)(1) of FECA provides that before review under section 8128(a) of this 

title, a claimant for compensation not satisfied with a decision of the Secretary is entitled, on 

request made within 30 days after the date of the issuance of the decision, to a hearing on his or 

her claim before a representative of the Secretary.19 Section 10.615 of the federal regulations 

implementing this section of FECA provides that a claimant shall be afforded a choice of an oral 

hearing or a review of the written record.20 OWCP regulations provide that the request must be 

sent within 30 days of the date of the decision for which a hearing is sought and also that the 

claimant must not have previously submitted a reconsideration request (whether or not it was 

granted) on the same decision.21

The Board has held that OWCP, in its broad discretionary authority in the administration 

of FECA,22 has the power to hold hearings in certain circumstances where no legal provision was 

made for such hearings and that OWCP must exercise this discretionary authority in deciding 

whether to grant a hearing.23 OWCP procedures, which require OWCP to exercise its discretion 

to grant or deny a hearing when the request is untimely or made after reconsideration, are a 

proper interpretation of FECA and Board precedent.24

 16 20 C.F.R. § 10.300 provides that, when an employee sustains a work-related traumatic injury requiring medical 

treatment, the employing establishment should issue a CA-16 form. 

17 See 20 C.F.R. § 10.300(c); Tracy P. Spillane, 54 ECAB 608 (2003). 

18 See P.B., Docket No. 14-837 (issued August 12, 2014). 

19 5 U.S.C. § 8124(b)(1). 

20 20 C.F.R. § 10.615. 

21 Id. at § 10.616(a). 

22 5 U.S.C. §§ 8101-8193. 

23 Marilyn F. Wilson, 52 ECAB 347 (2001). 

24 Teresa M. Valle, 57 ECAB 542 (2006). 
7

ANALYSIS -- ISSUE 2 

In the present case, appellant requested review of the written record on June 17, 2014. 

Her request was made more than 30 days after the date of issuance of OWCP’s prior May 13, 

2014 merit decision. Therefore, OWCP properly found in its July 15, 2014 decision that 

appellant was not entitled to an oral hearing or examination of the written record as a matter of 

right because her request was not made within 30 days of its May 13, 2014 decision.25

OWCP then properly exercised its discretion by stating that it had considered the matter 

and had denied appellant’s request for an examination of the written record because the issue of 

causal relationship could be addressed through a reconsideration application. The Board has 

held that the only limitation on OWCP’s authority is reasonableness and an abuse of discretion is 

generally shown through proof of manifest error, clearly unreasonable exercise of judgment, or 

actions taken which are contrary to both logic and probable deduction from established facts.26 

In this case, the evidence of record does not indicate that OWCP abused its discretion in its 

denial of appellant’s request for an examination of the written record. Accordingly, the Board 

finds that OWCP properly denied her request.27

CONCLUSION 

The Board finds that appellant has not established that she sustained a right wrist fracture 

in the performance of duty on February 4, 2014. The Board further finds that OWCP properly 

denied her request for review of the written record as untimely. Upon return of the case record, 

OWCP should address the issue of whether appellant is entitled to reimbursement of medical 

expenses pursuant to the Form CA-16. 

 25 20 C.F.R. § 10.616(a); FECA Manual, Part 2 -- Claims, Hearings and Reviews of the Written Record, Chapter 

2.1601.4(a) (October 2011). 

26 Daniel J. Perea, 42 ECAB 214, 221 (1990). 

27 D.P., Docket No. 14-308 (issued April 21, 2014); D.J., Docket No. 12-1332 (issued June 21, 2013). 
8

ORDER 

IT IS HEREBY ORDERED THAT the July 15, 2014 decision of the Office of 

Workers’ Compensation Programs is affirmed and the May 13, 2014 decision is affirmed, as 

modified. 

Issued: June 24, 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