United States Department of Labor 

Employees’ Compensation Appeals Board 

___________________________________________

B.S., Appellant 

and 

DEPARTMENT OF THE INTERIOR, 

NATIONAL PARK SERVICE, REGULAR 

EMPLOYEE FUNCTIONS, Luray, VA, 

Employer 

___________________________________________

) 

) 

) 

) 

) 

) 

) 

) 

) 

) 

Docket No. 16-1122 

Issued: October 17, 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 

COLLEEN DUFFY KIKO, Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On May 5, 2016 appellant filed a timely appeal from a February 25, 2016 merit decision 

and a March 28, 2016 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 these issues.2

ISSUES 

The issues are: (1) whether appellant met his burden of proof to establish a traumatic 

injury causally related to a May 13, 2015 employment incident; and (2) whether OWCP properly 

 1

 5 U.S.C. § 8101 et seq.

2

 On appeal appellant submitted new evidence. The Board cannot consider this evidence on appeal, however, as 

its review of the case is limited to the evidence of record which was before OWCP at the time of its final decision. 

20 C.F.R. § 501.2(c)(1); see Steven S. Saleh, 55 ECAB 169 (2003). 
2

refused to reopen appellant’s case for further review of the merits of his claim under 

5 U.S.C. § 8128(a). 

FACTUAL HISTORY 

On December 14, 2015 appellant, then a 40-year-old tractor operator, filed a traumatic 

injury claim (Form CA-1) alleging that on May 13, 2015 he was working outdoors and installing 

blocks in the parking area. He noted that he was wearing appropriate clothing and insect 

repellant. Appellant indicated that he found an imbedded deer tick in his stomach. He did not 

stop work. The employing establishment checked the box marked “yes” in response to whether 

appellant was injured in the performance of his duties and with regard to whether the knowledge 

of the facts about the injury agreed with the statements of the employee and/or witnesses. In a 

separate statement, it also noted that appellant routinely worked outdoors and had logged several 

instances of deer tick bites in the past. 

In a December 16, 2015 letter, OWCP advised appellant that additional factual and 

medical evidence was needed. It informed him of the type of evidence needed to support his 

claim and requested that he submit such evidence within 30 days. No evidence was received. 

By decision dated January 29, 2016, OWCP denied appellant’s claim as he had not 

established an injury as alleged, finding that he had not submitted any medical evidence and 

there was no evidence to support that an injury and or medical condition occurred. 

On February 1, 2016 appellant provided a January 4, 2016 report from Dr. Sasha L. 

Grams, Board-certified in family medicine. Dr. Grams noted that he saw appellant on 

November 30, 2015 with the chief complaint of fatigue, which appellant related going on for 

about two weeks and advised that “the fatigue felt similar to a prior episode of Lyme disease.” 

He noted that the last tick bite that appellant could remember was reported as a work-related 

injury occurring on May 13, 2015. Dr. Grams reported that appellant continued to work 

outdoors for the employing establishment although he could not recall any tick bites since then. 

He explained that a Lyme titer done on December 2, 2015 came back nonreactive. Dr. Grams 

advised that he ordered other tests as part of the work up and noted that they all were essentially 

normal. He explained that he suspected Lyme disease, which might not show up on testing, and 

started him on a course of doxycycline. Dr. Grams noted that appellant had a dramatic 

improvement in his fatigue with return to his baseline energy level within a short time of being 

on doxycycline. He opined that “the most likely explanation for his fatigue was Lyme disease 

due to tick bite given the resolution of his symptoms with treatment for this.” 

On February 10, 2016 appellant requested reconsideration. 

By decision dated February 25, 2016, OWCP modified the January 29, 2016 decision, 

finding that appellant submitted medical evidence diagnosing a condition, but that the claim 

remained denied as the medical evidence did not contain rationale to support causal relationship. 

On March 10, 2016 appellant requested reconsideration. 

In a March 10, 2016 letter, Michelle Kerns, an administrative officer with the employing 

establishment, confirmed that appellant documented a tick exposure at work on May 13, 2015. 
3

She also indicated that appellant was constantly working outdoors in the field and was routinely 

exposed to ticks and the elements in the park. Ms. Kerns explained that appellant did not 

become ill from his exposure until December, which was common in tick exposure cases. She 

attached a copy of tick report documenting his exposure. 

By decision dated March 28, 2016, OWCP denied appellant’s request for reconsideration 

without a review of the merits as the evidence submitted was insufficient to warrant review of 

the February 25, 2016 decision. It explained that the factual evidence from the employing 

establishment was irrelevant, as it failed to address the deficiencies in the medical evidence. 

OWCP advised that appellant had not provided diagnostic testing results to confirm that 

appellant in fact contracted Lyme disease and he did not provide a physician’s well-reasoned 

opinion explaining how the May 13, 2015 tick exposure was related to the diagnosed Lyme 

disease.

LEGAL PRECEDENT -- ISSUE 1 

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 timely filed within the 

applicable time limitation period of FECA,3 and that an injury was sustained in the performance 

of duty.4 These are the essential elements of each compensation claim, regardless of whether the 

claim is predicated upon a traumatic injury or an occupational disease.5

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

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

There are two components involved in establishing the 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.6 In some traumatic injury cases, this component can 

be established by an employee’s uncontroverted statement on the Form CA-1.7

 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.8

 

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 

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

4 James E. Chadden, Sr., 40 ECAB 312 (1988). 

5 Delores C. Ellyett, 41 ECAB 992 (1990). 

6 Julie B. Hawkins, 38 ECAB 393, 396 (1987). 

7 John J. Carlone, 41 ECAB 354 (1989). 

8 Id. For a definition of the term “traumatic injury,” see 20 C.F.R. § 10.5(ee). 
4

rationale explaining the nature of the relationship between the diagnosed condition and the 

specific employment factors identified by the claimant.9

ANALYSIS -- ISSUE 1 

In this case, appellant alleged that on May 13, 2015 he sustained a tick bite in the 

performance of duty. OWCP accepted that the tick bite occurred. The issue to be determined is 

whether the medical evidence established that appellant’s diagnosed condition is causally related 

to the May 13, 2015 employment incident. 

The Board finds that the medical evidence is insufficiently rationalized to establish the 

second component of fact of injury, that the employment incident caused an injury. The medical 

evidence contains no reasoned explanation of how the specific employment incident on May 13, 

2015 caused or aggravated an injury.10 

Appellant submitted a January 4, 2016 report from Dr. Gram, who noted that he saw 

appellant on November 30, 2015 for fatigue of weeks’ duration which appellant felt to be similar 

to a prior episode of Lyme disease. Dr. Gram noted that the last tick bite that appellant could 

remember was reported as a work-related injury occurring on May 13, 2015. However, he 

indicated that a Lyme titer test performed on December 2, 2015 came back nonreactive and other 

tests were essentially normal. Dr. Gram explained that he “suspected Lyme disease, which 

might not show up on testing, and started him on a course of doxycycline.” He indicated that 

appellant had a dramatic improvement in his fatigue with return to his baseline energy level 

within a short time of being on doxycycline and concluded that “the most likely explanation for 

his fatigue was Lyme disease due to tick bite given the resolution of his symptoms with 

treatment for this.” 

The Board finds, however, that Dr. Gram did not provide a definitive diagnosis, as he 

indicated he suspected Lyme disease despite testing being nonreactive and normal. Further, his 

opinion is speculative regarding causal relationship. Dr. Gram indicated that the most likely 

explanation for appellant’s condition was the tick bite, as his symptoms resolved after treatment. 

The Board has held that speculative and equivocal medical opinions regarding causal 

relationship have no probative value.11 Moreover, Dr. Gram did not explain how appellant’s 

condition was caused by the accepted May 13, 2015 employment incident. Medical reports 

without adequate rationale on causal relationship are of diminished probative value and do not 

meet an employee’s burden of proof.12 

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

10 See George Randolph Taylor, 6 ECAB 986, 988 (1954) (where the Board found that a medical opinion not 

fortified by medical rationale is of little probative value). 

11 Ricky S. Storms, 52 ECAB 349 (2001) (while the opinion of a physician supporting causal relationship need not 

be one of absolute medical certainty, the opinion must not be speculative or equivocal. The opinion should be 

expressed in terms of a reasonable degree of medical certainty). 

12 See R.C., Docket No. 15-315 (issued May 4, 2015); Ceferino L. Gonzales, 32 ECAB 1591 (1981). 
5

Because the medical report submitted by appellant does not address how the May 13, 

2015 incident at work caused or aggravated his Lyme disease, this report is of limited probative 

value13 and it is insufficient to establish that the May 13, 2015 employment incident caused or 

aggravated a specific injury. 

The Board notes that OWCP procedures provide that in certain circumstances no medical 

report is required where all of the following criteria are satisfied, a claim may be accepted 

without a medical report: (1) The condition reported is a minor one which can be identified on 

visual inspection by a lay person (e.g., burn, laceration, insect sting or animal bite); (2) The 

injury was witnessed or reported promptly, and no dispute exists as to the fact of injury; and 

(3) No time was lost from work due to disability.14 These procedures do not apply in this 

situation. Although it is undisputed that he received a tick bite, the issue is whether the tick bite 

caused the Lyme disease symptoms, a condition that could be identified on visual inspection and 

in fact test results could not confirm. As found above, the report from Dr. Gram is speculative 

and not rationalized. 

On appeal, appellant argued that his physician, Dr. Grams, made a clinical diagnosis and 

his report was conclusive. He also argued that his personal physician also noted that it was 

common to have symptoms, but the blood test was negative. The Board finds, however, that the 

medical evidence is insufficient to establish a medical condition related to the accepted tick bite. 

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. 

LEGAL PRECEDENT -- ISSUE 2 

Under section 8128(a) of FECA,15 OWCP may reopen a case for review on the merits in 

accordance with the guidelines set forth in section 10.606(b)(3) of the implementing federal 

regulations, which provides that a claimant may obtain review of the merits if the written 

application for reconsideration, including all supporting documents, sets forth arguments and 

contains evidence which: 

“(i) Shows that OWCP erroneously applied or interpreted a specific point of law; 

or 

“(ii) Advances a relevant legal argument not previously considered by OWCP; or 

“(iii) Constitutes relevant and pertinent new evidence not previously considered 

by OWCP.”16

 13 See Linda I. Sprague, 48 ECAB 386, 389-90 (1997). 

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

15 5 U.S.C. § 8128(a). 

16 20 C.F.R. § 10.606(b). 
6

 Section 10.608(b) provides that any application for review of the merits of the claim 

which does not meet at least one of the requirements listed in section 10.606(b) will be denied by 

OWCP without review of the merits of the claim.17

ANALYSIS 

Appellant disagreed with the denial of his claim for a traumatic injury and requested 

reconsideration on March 10, 2016. The underlying issue on reconsideration is medical in 

nature, whether the May 13, 2015 tick bite caused Lyme disease or any other medical condition. 

Appellant, however, did not provide any relevant or pertinent new evidence to the issue 

of whether he sustained a traumatic injury due to his tick bite on May 13, 2015. 

On reconsideration, appellant submitted documentation from the employing 

establishment confirming that he was bitten by a tick on May 13, 2015. However, the factual 

component of his claim had already been accepted. The relevant issue in this claim is medical in 

nature and must therefore be resolved by the submission of relevant medical evidence.18 Thus, 

this evidence is irrelevant. Appellant did not submit new medical evidence, but rather submitted 

additional factual evidence. The submission of evidence that does not address the particular 

issue involved does not constitute a basis for reopening a case.19 

Consequently, the evidence submitted by appellant on reconsideration does not satisfy the 

third criterion, noted above, for reopening a claim for merit review. Furthermore, appellant also 

has not shown that OWCP erroneously applied or interpreted a specific point of law, or advanced 

a relevant new argument not previously submitted. Therefore, OWCP properly denied his 

request for reconsideration. 

CONCLUSION 

The Board finds that appellant failed to meet his burden of proof to establish a traumatic 

injury causally related to the May 13, 2015 employment incident. The Board also finds that 

OWCP properly refused to reopen appellant’s case for further review of the merits of his claim 

under 5 U.S.C. § 8128(a). 

 17 Id. at § 10.608(b). 

18 See Paul Foster, 56 ECAB 208 (2004).

19 Alan G. Williams, 52 ECAB 180 (2000); Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000); Robert P. 

Mitchell, 52 ECAB 116 (2000). 
7

ORDER 

IT IS HEREBY ORDERED THAT the March 28 and February 25, 2016 decisions of 

the Office of Workers’ Compensation Programs are affirmed. 

Issued: October 17, 2016 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board