United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

S.D., Appellant 

and 

DEPARTMENT OF LABOR, OFFICE OF 

WORKERS’ COMPENSATION PROGRAMS, 

Washington, DC, Employer 

__________________________________________ 

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Docket No. 16-0301 

Issued: April 1, 2016 

Appearances: Case Submitted on the Record

Appellant, pro se 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

COLLEEN DUFFY KIKO, Judge 

JURISDICTION 

On December 8, 2015 appellant filed a timely appeal from a July 7, 2015 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 merits of this case. 

ISSUE 

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

atrial fibrillation in the performance of duty. 

FACTUAL HISTORY 

On October 8, 2014 appellant, then a 63-year-old compensation claims examiner, filed a 

traumatic injury claim (Form CA-1) alleging that she sustained chest pressure on September 24, 

 1

 5 U.S.C. § 8101 et seq. 
2

2014 after a claimant she telephoned allegedly became verbally abusive and called her a racist. 

She stopped work within hours of the incident and returned to work on October 6, 2014. 

In a November 3, 2014 letter, OWCP advised appellant of the evidence needed to 

establish her claim, including factual evidence corroborating the September 24, 2014 incident, 

medical evidence containing a definite diagnosis, and her physician’s explanation of how and 

why the identified work factors would cause the diagnosed condition. It afforded appellant 30 

days to submit such evidence. 

In response, appellant submitted a statement dated November 17, 2014. She noted that 

she called a claimant at approximately 5:30 p.m. on September 24, 2014, at the end of the work 

shift, as he was known to be abusive to claims examiners. Appellant alleged that during the 

September 24, 2014 telephone call, the claimant “went into a tirade,” accused appellant of 

favoring “Mexican buddies and immigrants,” losing his paperwork, and being a racist. She then 

ended the conversation. Appellant shut down her computer and walked to the elevator. She 

described feeling like she was “pulling a bag of bricks” when walking, with “fullness pressure 

sensations” in her chest. When appellant arrived home, her husband insisted on taking her to a 

hospital walk-in center where she was evaluated, then referred to the cardiac unit of a second 

hospital. She asserted that she had no prior history of a cardiac condition, hypertension, 

coronary artery disease, or psychiatric condition. Appellant noted that prior to an April 2007 

shoulder surgery, she was evaluated for possible bradycardia but was not formally diagnosed or 

treated. 

Appellant provided telephone memoranda (CA-110 forms) dated June 19, July 10 and 17, 

September 2, 24, and 25, 2014 documenting calls to and from the claimant. The other claims 

examiners who spoke with the same particular claimant in June and July, 2014 described him as 

angry and complaining. Appellant spoke to the claimant on September 2 and 24, 2014, and 

described him in the memoranda as irate and complaining. She noted in the September 24, 2014 

memorandum that the claimant called her a racist, contacted news media, and filed a complaint 

against her. 

Appellant also provided medical evidence. Dr. Tuan-Anh Vu, a physician Boardcertified in emergency medicine, evaluated her at 9:31 p.m. on September 24, 2014. He 

diagnosed atrial fibrillation with acute chest pain. Appellant also submitted September 27, 2014 

hospital discharge instructions for atrial fibrillation. 

In a November 5, 2014 report, Dr. Alfred C. Burris, an attending Board-certified 

cardiologist, noted that appellant’s heart rhythm converted spontaneously to sinus rhythm while 

she was hospitalized. He related appellant’s account of a “stressful setting at work” due to “a 

client who was very demanding and very irate” during a telephone call the day of her 

hospitalization. Dr. Burris explained that atrial fibrillation “is tied in with stress.” He opined 

that it did “appear that the job stress may have aggravated and definitely contributed to the 

episode of atrial fibrillation.” Dr. Burris advised appellant to avoid stressful settings as much as 

possible. He held her off work from September 25 to October 6, 2014. 

By decision dated December 4, 2014, OWCP denied the claim finding that the medical 

evidence did not establish causal relationship. It accepted that the September 24, 2014 telephone 
3

conversations occurred as alleged. However, appellant’s physicians did not explain how and 

why these work factors would cause atrial fibrillation. OWCP found that Dr. Burris’ opinion 

was speculative and equivocal in nature. 

Appellant disagreed and requested a hearing, held April 17, 2015. At the hearing, she 

noted that, after the September 24, 2014 telephone call at the end of her work shift, she 

experienced fatigue, but drove herself home. Appellant spoke with her husband, and had a 

sensation that she could not breathe freely. Her brother then stopped by her house and remarked 

that she did not look well. At that point appellant’s husband took her to the hospital where she 

remained overnight. In the morning she was transferred to a second hospital where she was 

diagnosed with atrial fibrillation. Appellant was discharged two days after she reported to the 

emergency room. She stated that she had no history of atrial fibrillation prior to September 24, 

2014 and had no subsequent episodes. Appellant remained off work for one week to consult a 

specialist, who released her to work. 

Following the hearing, appellant submitted an April 8, 2015 report from Dr. Burris. 

Dr. Burris noted that appellant had a normal cardiac workup in 2007 prior to undergoing 

shoulder surgery. He reiterated appellant’s account of the September 24, 2014 telephone call, 

the onset of chest pain, and hospitalization. Dr. Burris characterized her cardiac workup as 

“essentially negative.” He noted that appellant had no chest pain or documented arrhythmias 

since her discharge from the hospital on September 27, 2014. Dr. Burris opined that it therefore 

seemed “clear that the stressful environment that day at work created an excessive amount of 

adrenaline from her conversation with the above-referenced client. It does appear that this 

increased adrenaline triggered the electrical atrial fibrillation activity.”2

 

By decision dated and finalized July 7, 2015, an OWCP hearing representative affirmed 

the December 4, 2014 decision, finding that causal relationship had not been established. He 

found that the September 24, 2014 telephone call occurred at the time, place, and in the manner 

alleged. However, the medical evidence remained insufficient to establish that the telephone call 

caused or contributed to the incident of atrial fibrillation. The hearing representative found that 

Dr. Burris failed to provide adequate medical reasons for supporting causal relationship. Rather 

he noted the temporal relationship between the onset of atrial fibrillation and the September 24, 

2014 telephone call. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA has the burden of proof to establish 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 and/or specific condition for which compensation is claimed are causally related to 

 2

 Appellant also provided a copy of her position description, and a December 30, 2014 statement from her 

husband corroborating that appellant complained of chest pain after arriving home from work on 

September 24, 2014. He then took her to the hospital walk-in center. 
4

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 sustained a traumatic injury in the 

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

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

conjunctively. First, the employee must submit sufficient evidence to establish that he or she 

actually experienced the employment incident that is alleged to have occurred.5 An employee 

has not met his or her burden of proof 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.6

 

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.7

 

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 medial 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 

Appellant claimed that she sustained atrial fibrillation on September 24, 2014 when 

speaking by telephone to an irate claimant. OWCP accepted that the September 24, 2014 

telephone call occurred as alleged, but denied the claim as causal relationship was not 

established. 

In support of her claim, appellant submitted reports from Dr. Burris, an attending Boardcertified cardiologist. Dr. Burris related appellant’s account of the September 24, 2014 

telephone call with the subsequent onset of chest pressure and fullness. On November 5, 2014 

he commented that it did “appear that the job stress may have aggravated and definitely 

contributed to the episode of atrial fibrillation.” This opinion is speculative in nature, and is 

therefore insufficient to meet appellant’s burden of proof.9

 In an April 8, 2015 report, Dr. Burris 

 3 Joe D. Cameron, 41 ECAB 153 (1989). 

4 See Irene St. John, 50 ECAB 521 (1999); Michael E. Smith, 50 ECAB 313 (1999). 

5 Gary J. Watling, 52 ECAB 278 (2001). 

6 S.N., Docket No. 12-1222 (issued August 23, 2013); Tia L. Love, 40 ECAB 586, 590 (1989). 

7 Deborah L. Beatty, 54 ECAB 340 (2003).

8 Solomon Polen, 51 ECAB 341 (2000). 

9 Ricky S. Storms, 52 ECAB 349 (2001). 
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opined that because appellant only experienced one episode of atrial fibrillation close to the time 

of the September 24, 2014 telephone call, that it appeared that increased adrenaline from stress 

triggered atrial fibrillation. The Board has held, however, that a temporal relationship alone is 

insufficient to establish causal relationship.10 Dr. Burris did not specify if any clinical findings 

or laboratory studies during appellant’s hospital stay confirmed his theory of increased 

adrenaline. In the absence of such rationale, his opinion is insufficient to meet appellant’s 

burden of proof.11

OWCP advised appellant by November 3, 2014 letter of the necessity of providing her 

physician’s well-reasoned opinion explaining how and why work factors would cause the cardiac 

episode. As appellant did not submit such evidence, OWCP properly denied the claim. 

On appeal, appellant contends that Dr. Burris provided sufficient rationale to meet her 

burden of proof to establish the asserted causal relationship between the September 24, 2014 

telephone call and the episode of atrial fibrillation. She cites Dr. Burris’ theory that work stress 

created excess adrenaline that triggered atrial fibrillation. Appellant also quotes the Board’s 

holdings in Beth P. Chaput,

12 Glenn C. Chasteen,13 and Arnold Gustafson,14 that, if work factors 

contributed to the development of a condition in any way, the condition should be considered 

compensable under FECA. However, the present case is distinguished from these cited decisions 

because appellant has not submitted rationalized medical evidence establishing that the 

September 24, 2014 telephone call contributed in any way to the onset of atrial fibrillation. 

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 has not met her burden of proof to establish that she 

sustained an episode of atrial fibrillation in the performance of duty. 

 10 Louis R. Blair, Jr., 54 ECAB 348 (2003). 

11 Deborah L. Beatty, 54 ECAB 340 (2003).

12 37 ECAB 158 (1985). 

13 42 ECAB 493 (1991). 

14 41 ECAB 131 (1989). 
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ORDER 

IT IS HEREBY ORDERED THAT the decision of the Office of Workers’ 

Compensation Programs dated July 7, 2015 is affirmed. 

Issued: April 1, 2016 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board