United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

T.G., Appellant 

and 

DEPARTMENT OF THE INTERIOR, BUREAU 

OF RECLAMATION, Boulder City, NV, 

Employer 

__________________________________________ 

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Docket No. 15-12 

Issued: June 1, 2015 

Appearances: Case Submitted on the Record

Lonnie Boylan, for the appellant 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On October 3, 2014 appellant, through her representative, filed a timely appeal from a 

September 16, 2014 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. 

ISSUE 

The issue is whether appellant met her burden of proof to establish that her stress 

conditions are causally related to an August 2, 2013 employment incident, as alleged. 

On appeal, appellant’s representative contends that the medical evidence submitted is 

sufficient to establish that appellant sustained post-traumatic stress disorder as a result of being 

trapped alone in a dark disabled elevator with no means of communication with the outside 

world. He requests that OWCP’s decision be set aside and the case remanded for further 

 1

 5 U.S.C. § 8101 et seq. 
2

development until such time as it is in posture for a de novo decision in regards to appellant’s 

claim. 

FACTUAL HISTORY 

On August 2, 2013 appellant, then a 52-year-old administrative support assistant, filed a 

traumatic injury claim (Form CA-1) alleging that her stress level and blood pressure rose as a 

result of being trapped in a disabled elevator for 20 minutes while in the performance of duty 

that day. 

An OWCP Form CA-16, authorization for examination, was issued by the employing 

establishment on August 2, 2013. Appellant was authorized to visit Boulder City Hospital in 

Boulder City, Nevada. She submitted hospital records dated August 2, 2013 from her visit to the 

emergency department at Boulder City Hospital. 

In an August 27, 2013 letter, OWCP indicated that, when appellant’s claim was received, 

it appeared to be a minor injury that resulted in minimal or no lost time from work and, based on 

these criteria and because the employing establishment did not controvert continuation of pay or 

challenge the case, payment of a limited amount of medical expenses was administratively 

approved. It indicated that it had reopened the claim for consideration because it had received an 

indication that she had not returned to work in a full-time capacity. OWCP requested additional 

evidence and afforded appellant 30 days to respond to its inquiries. 

Appellant submitted reports dated August 5 and 15, 2013 from Dr. Irfan Tahir, a Boardcertified internist, who diagnosed anxiety and benign essential hypertension. Dr. Tahir indicated 

that appellant complained of stress and anxiety at work and also had high blood pressure. 

In reports dated August 22 and September 11, 2013, Dr. Kristina Shurtleff, a Boardcertified family practitioner, diagnosed generalized anxiety disorder, benign essential 

hypertension, chest pain, and pain in joint, multiple sites. She indicated that appellant was seen 

at the emergency room on August 2, 2013, was given medicine to drop her blood pressure, and 

then released after two hours when she felt better. Dr. Shurtleff stated that appellant was having 

chest pains and cried for no reason with the stress from her work. 

By decision dated October 4, 2013, OWCP denied appellant’s claim on the basis that the 

medical evidence failed to establish a causal relationship between his conditions and the 

August 2, 2013 employment incident. 

On June 18, 2014 appellant, through her representative, requested reconsideration and 

submitted a May 1, 2014 report from Dr. Daniel Shiode, appellant’s clinical psychologist, who 

diagnosed post-traumatic stress disorder. Dr. Shiode indicated that appellant was trapped in an 

elevator at work on August 2, 2013. Appellant perceived the incident as being potentially life 

threatening and was terrified by what occurred. Dr. Shiode indicated that appellant developed 

several signs and symptoms indicative of post-traumatic stress disorder, including exposure to an 

extreme stressor that involved actual or threatened death or injury, response involving intense 

fear, helplessness or horror, and symptoms including intrusive flashbacks, avoidance behaviors, 

and increased arousal symptoms. He opined that appellant met “all of these criteria with 
3

reference to the elevator incident” and noted that there was “no indication of preexisting 

psychological condition, or any prior history of trauma that would account for the development 

of her symptoms.” 

By decision dated September 16, 2014, OWCP denied modification of the October 4, 

2013 decision. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA2 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 timely filed within the applicable time 

limitation period of FECA, that an injury3

 was sustained in the performance of duty, as alleged, 

and that any disability or medical condition for which compensation is claimed is causally 

related to the employment injury.4

 

To determine whether a federal employee has sustained a traumatic injury in the 

performance of duty, it must first be determined whether a “fact of injury” has been established. 

A fact of injury determination is based on two elements. First, the employee must submit 

sufficient evidence to establish that she actually experienced the employment incident at the 

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

generally only in the form of medical evidence, to establish that the employment incident caused 

a personal injury. An employee may establish that the employment incident occurred as alleged 

but fail to show that his or her condition relates to the employment incident.5 

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

establish causal relationship is rationalized medical opinion evidence. The opinion of the 

physician must be based on a complete factual and medical background of the employee, 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 employee.6

 

 2 Id. 

3

 OWCP regulations define a traumatic injury as a condition of the body caused by a specific event or incident, or 

series of events or incidents, within a single workday or shift. Such condition must be caused by external force, 

including stress or strain, which is identifiable as to time and place of occurrence and member or function of the 

body affected. 20 C.F.R. § 10.5(ee). 

4 See T.H., 59 ECAB 388 (2008). See also Steven S. Saleh, 55 ECAB 169 (2003); Elaine Pendleton, 40 ECAB 

1143 (1989). 

5 Id. See Shirley A. Temple, 48 ECAB 404 (1997); John J. Carlone, 41 ECAB 354 (1989). 

6 Id. See Gary J. Watling, 52 ECAB 278 (2001). 
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ANALYSIS 

OWCP has accepted that the employment incident of August 2, 2013 occurred at the 

time, place, and in the manner alleged. The issue is whether appellant’s stress-related emotional 

conditions resulted from the August 2, 2013 employment incident. The Board finds that 

appellant did not meet her burden of proof to establish a causal relationship between the 

conditions for which compensation is claimed and the employment incident. 

In a report dated May 1, 2014, Dr. Shiode diagnosed post-traumatic stress disorder. He 

indicated that appellant was trapped in an elevator at work on August 2, 2013. Appellant 

perceived the incident as life threatening and was terrified by what occurred. Dr. Shiode 

indicated that appellant developed several signs and symptoms indicative of post-traumatic stress 

disorder, including exposure to an extreme stressor that involved actual or threatened death or 

injury, a response involving intense fear, helplessness or horror. He identified symptoms 

including intrusive flashbacks, avoidance behaviors, and increased arousal symptoms. 

Dr. Shiode opined that appellant met “all of these criteria with reference to the elevator incident” 

and noted that there was “no indication of preexisting psychological condition, or any prior 

history of trauma that would account for the development of her symptoms.” 

Dr. Shiode’s report did not contain medical rationale explaining the mechanism of how 

appellant’s post-traumatic stress disorder was caused or aggravated by being trapped in a 

disabled elevator for 20 minutes. Although he noted that her condition occurred after being 

trapped in an elevator at work, such generalized statements do not establish causal relationship 

because they merely repeat appellant’s allegations and are otherwise unsupported by adequate 

medical rationale explaining how this physical activity actually caused the diagnosed 

conditions.7

 Thus, the Board finds that the report from Dr. Shiode is insufficient to establish that 

appellant sustained an employment-related injury in the performance of duty on August 2, 2013. 

In her reports, Dr. Shurtleff diagnosed generalized anxiety disorder, benign essential 

hypertension, chest pain, and pain in joint, multiple sites. She indicated that appellant was seen 

at the emergency room on August 2, 2013, was given medicine to drop her blood pressure, and 

then released after two hours when she felt better. Dr. Shurtleff stated that appellant experienced 

chest pains and cried for no reason with the stress from her work. The Board finds that 

Dr. Shurtleff did not provide medical rationale establishing that being trapped in a disabled 

elevator for 20 minutes on August 2, 2013 caused or aggravated the diagnosed conditions. Thus, 

the Board finds Dr. Shurtleff’s reports are of limited probative value and fail to establish 

appellant’s claim. 

In his reports, Dr. Tahir diagnosed anxiety and benign essential hypertension and 

indicated that appellant complained of stress and anxiety at work. The report did not contain an 

opinion from him about whether appellant’s complaints were work related. The Board has held 

that medical evidence that does not offer any opinion regarding the cause of an employee’s 

 7 See K.W., Docket No. 10-98 (issued September 10, 2010). 
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condition is of limited probative value on the issue of causal relationship.8

 Thus, appellant has 

not met her burden of proof with this submission. 

In support of her claim, appellant submitted hospital records dated August 2, 2013 from 

her visit to the emergency department at Boulder City Hospital. These documents are not 

competent medical opinion evidence because they do not contain rationale by a physician 

relating appellant’s injury to her employment.9 The Board finds that appellant did not meet her 

burden of proof with these submissions. 

Because appellant has not submitted any rationalized medical evidence to support her 

allegation that she sustained an injury causally related to the August 2, 2013 employment 

incident, she has failed to meet her burden of proof to establish a claim. 

On appeal, appellant’s representative contends that the medical evidence submitted is 

sufficient to establish that appellant sustained post-traumatic stress disorder as a result of being 

trapped alone in a dark disabled elevator with no means of communication with the outside 

world. He requests that OWCP’s decision be set aside and the case remanded for further 

development until such time as it is in posture for a de novo decision on appellant’s claim. As 

noted, appellant bears the burden of proof to establish that her conditions are causally related to 

the employment incident.10 Based on the findings and reasons stated above, the Board finds the 

representative’s arguments are not substantiated. 

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

August 2, 2013 authorizing medical treatment. The Board has held that where an 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, it creates a contractual obligation, which 

does not involve the employee directly, to pay the cost of the examination or treatment regardless 

of the action taken on the claim.11 Although OWCP denied appellant’s claim for an injury, it did 

not address whether she is entitled to reimbursement of medical expenses pursuant to the Form 

CA-16. Upon return of the case record, OWCP should further address this issue. 

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. 

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

9 See 5 U.S.C. § 8101(2). Section 8101(2) of FECA provides as follows: “(2) ‘physician’ includes surgeons, 

podiatrists, dentists, clinical psychologists, optometrists, chiropractors, and osteopathic practitioners within the 

scope of their practice as defined by State law.” See also Paul Foster, 56 ECAB 208, 212 n.12 (2004); Joseph N. 

Fassi, 42 ECAB 677 (1991); Barbara J. Williams, 40 ECAB 649 (1989). 

10 See supra note 3-7. 

11 See D.M., Docket No. 13-535 (issued June 6, 2013). See also 20 C.F.R. §§ 10.300, 10.304. 
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CONCLUSION 

The Board finds that appellant has not met her burden of proof to establish that her stress 

conditions are causally related to an August 2, 2013 employment incident, as alleged. On return 

of the record, OWCP should consider the Form CA-16 issued in this case. 

ORDER 

IT IS HEREBY ORDERED THAT the September 16, 2014 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: June 1, 2015 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board