United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

D.L., Appellant 

and 

DEPARTMENT OF THE TREASURY, 

INTERNAL REVENUE SERVICE, 

Kansas City, MO, Employer 

__________________________________________ 

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Docket No. 16-0466 

Issued: July 18, 2016 

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

COLLEEN DUFFY KIKO, Judge 

ALEC J. KOROMILAS, Alternate Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On January 13, 2016 appellant, through counsel, filed a timely appeal from a 

September 4, 2015 merit decision of the Office of Workers’ Compensation Programs (OWCP). 

Pursuant to the Federal Employees’ Compensation Act2 (FECA) and 20 C.F.R. §§ 501.2(c) and 

501.3, the Board has jurisdiction over the merits of this case. 

 1

 In all cases in which a representative has been authorized in a matter before the Board, no claim for a fee for 

legal or other service performed on appeal before the Board is valid unless approved by the Board. 20 C.F.R. § 

501.9(e). No contract for a stipulated fee or on a contingent fee basis will be approved by the Board. Id. An 

attorney or representative’s collection of a fee without the Board’s approval may constitute a misdemeanor, subject 

to fine or imprisonment for up to one year or both. Id.; see also 18 U.S.C. § 292. Demands for payment of fees to a 

representative, prior to approval by the Board, may be reported to appropriate authorities for investigation. 

2

 5 U.S.C. § 8101 et seq. 
2

ISSUE 

The issue is whether appellant has met her burden of proof to establish an injury in the 

performance of duty. 

FACTUAL HISTORY 

On July 1, 2015 a traumatic injury claim was filed on appellant’s behalf. The employing 

establishment indicated that on June 24, 2015 appellant, then a 47-year-old clerk, fell in the 

parking garage and broke her hip as she was walking into the building. It controverted her claim 

because it attributed her fall to her history of dizziness related to high and low blood sugar. The 

employing establishment also indicated that security footage showed that appellant braced her 

fall with her arm on a doorway and that the incident was unlikely to have caused a traumatic 

injury unless an underlying medical condition existed. It noted that the health unit nurse 

indicated that appellant collapsed in the parking garage with possible heat exhaustion. The 

employing establishment advised that she was coming into the building from the garage when 

she collapsed “into the doorway on G1 center wing.” Appellant stopped work that day. 

By letter dated July 29, 2015, OWCP notified appellant of the evidence needed to 

establish the claim. It noted that the employing establishment was challenging the claim as she 

had a history of dizziness to high or low blood sugar. OWCP asked appellant to provide a 

detailed description of where she was and what she was doing when she fell. That same date 

OWCP requested information from the employing establishment regarding the ownership of the 

parking garage. No statement was received from either appellant or the employing 

establishment. 

In a June 25, 2015 report, Dr. John Bleazard, a Board-certified osteopath specializing in 

orthopedic surgery, advised that appellant fell on June 24, 2015 after a syncopal episode. He 

noted that appellant was hyperglycemic when she reported to the emergency department and that 

she had a history of diabetes mellitus. Dr. Bleazard indicated that she related that she was 

experiencing pain in the left lateral hip and groin. An x-ray revealed a minimally displaced 

intertrochanteric hip fracture. Dr. Bleazard diagnosed left intertrochanteric hip fracture. In a 

separate June 25, 2015 operative report, he noted performing a cephalomedullary nail fixation to 

treat the left intertrochanteric hip fracture. 

In a July 8, 2015 report, Dr. Bleazard advised that appellant was two weeks postsurgery 

and that she was doing well. On examination he noted a nicely healing incision, no signs of 

infection, intact light touch sensation, grossly normal muscle tone, and normal strength without 

atrophy. Dr. Bleazard noted that a left hip x-ray revealed that alignment was acceptable. 

An August 4, 2015 physical therapy report was submitted. The physical therapist advised 

that appellant became overheated in the garage at the employing establishment, that she had not 

been paying attention, and that the garage door came up and hit her on the hip. 

In an August 5, 2015 report, Dr. Bleazard advised that appellant was six weeks post left 

gamma nail surgery and that she was doing remarkably well, only experiencing intermittent pain 

at the end of the day. Examination revealed a healed incision, no erythema or signs of infection, 

intact sensation, grossly normal muscle tone, and normal strength without atrophy. Dr. Bleazard 
3

noted that alignment was acceptable and healing was evident. He recommended that appellant 

continue physical therapy and weight bearing as tolerated. In an August 5, 2015 disability status 

report, Dr. Bleazard advised that appellant was only able to work a sitting job. 

By decision dated September 4, 2015, OWCP denied appellant’s traumatic injury claim 

because the evidence was insufficient to establish that her injury arose during the course of 

employment and within the scope of compensable work factors. It noted that her injury was 

caused by an idiopathic incident noting that the evidence indicated that she had a syncope 

episode and was hyperglycemic. 

LEGAL PRECEDENT 

FECA provides for payment of compensation for disability or death of an employee 

resulting from personal injury sustained while in the performance of duty.3

 The phrase sustained 

while in the performance of duty is regarded as the equivalent of the coverage formula commonly 

found in workers’ compensation laws, namely, arising out of and in the course of employment.4 In 

the course of employment relates to the elements of time, place, and work activity. To arise in the 

course of employment, an injury must occur at a time when the employee may reasonably be said 

to be engaged in her master’s business, at a place when he or she may reasonably be expected to be 

in connection with his or her employment and while he or she was reasonably fulfilling the duties 

of his or her employment or engaged in doing something incidental thereto. As to the phrase in the 

course of employment, the Board has accepted the general rule of workers’ compensation law that, 

as to employees having fixed hours and places of work, injuries occurring on the premises of the 

employing establishment, while the employees are going to or from work, before or after working 

hours or at lunch time, are compensable.5

This alone is not sufficient to establish entitlement to benefits for compensability. The 

concomitant requirement of an injury “arising out of the employment” must be shown, and this 

encompasses not only the work setting but also a causal concept. The facts of the case must show 

some substantial employer benefit is derived or an employment requirement gave rise to the 

injury.6

It is a well-settled principle of workers’ compensation law, and the Board has so held, 

that an injury resulting from an idiopathic fall -- where a personal, nonoccupational pathology 

causes an employee to collapse and to suffer injury upon striking the immediate supporting 

surface, and there is no intervention or contribution by any hazard or special condition of 

 3 Id. at § 8102(a). 

4

 This construction makes the statute effective in those situations generally recognized as properly within the 

scope of workers’ compensation law. Bernard D. Blum, 1 ECAB 1 (1947). 

5 Narbik A. Karamian, 40 ECAB 617, 618 (1989). With regard to what constitutes the premises, the Board has 

stated that the term “premises” as it is generally used in workers’ compensation law, is not synonymous with 

property. The former does not depend on ownership, nor is it necessarily coextensive with the latter. In some cases 

premises may include all the property owned by the employing establishment; in other cases even though it does not 

have ownership and control of the place where the injury occurred the place is nevertheless considered part of the 

premises. Wilmar Lewis Prescott, 22 ECAB 318, 321 (1971). 

6

 See Eugene G. Chin, 39 ECAB 598, 602 (1988). 
4

employment -- is not within coverage of FECA.7

 Such an injury does not arise out of a risk 

connected with the employment and is, therefore, not compensable. The Board has made equally 

clear, the fact that the cause of a particular fall cannot be ascertained or that the reason it 

occurred cannot be explained, does not establish that it was due to an idiopathic condition. This 

follows from the general rule that an injury occurring on the industrial premises during working 

hours is compensable unless the injury is established to be within an exception to such general 

rule.8 If the record does not establish that the particular fall was due to an idiopathic condition, it 

must be considered as merely an unexplained fall, one which is distinguishable from a fall in 

which it is definitely proved that a physical condition preexisted and caused the fall.9

To properly apply the idiopathic fall doctrine, there must be two elements present: a fall 

resulting from a personal, nonoccupational pathology, and no contribution from the 

employment.10 If the record does not establish the fall was due to an idiopathic condition, it 

must be considered as merely an unexplained fall, which is covered under FECA. 

ANALYSIS 

The issue is whether appellant’s fall on June 24, 2015 arose in the performance of duty. 

The Board finds that the case is not in posture for a decision. 

As a preliminary matter, the Board finds that the case must be further developed with 

regard to whether appellant’s fall occurred on the employing establishment’s premises. As 

noted, the Board has held that injuries occurring on the premises of the employing establishment, 

while the employees are going to or from work, before or after working hours or at lunch time, are 

compensable.11 The employing establishment advised that appellant was coming into the 

building from the garage when she collapsed “into the doorway on G1 center wing.” It noted 

that security footage revealed a fall where appellant used her arm to brace herself on a doorway. 

An August 4, 2015 physical therapy report, however, advised that appellant related that she 

became overheated in the garage at the employing establishment and that a garage door came up 

and hit her on the hip. OWCP did not make a specific finding on the point and the Board has 

insufficient evidence to determine whether appellant’s fall occurred in the performance of duty.12 

The Board finds that OWCP did not adequately develop the question of whether appellant’s 

June 24, 2015 accident occurred in the performance of duty and will remand the case for further 

development on that aspect of the claim. 

Furthermore, the Board finds that OWCP has failed to meet its burden of proof to 

establish the existence of a prior pathology which caused the fall. 

 7 See Carol A. Lyles, 57 ECAB 265 (2005). 

8 Dora J. Ward, 43 ECAB 767, 769 (1992); Fay Leiter, 35 ECAB 176, 182 (1983). 

9 John R. Black, 49 ECAB 624 (1998); Judy Bryant, 40 ECAB 207 (1988); Martha G. List, 26 ECAB 200 (1974). 

10 E.C., Docket No. 15-0823 (issued February 2, 2016). 

11 See supra note 4. 

12 See M.C., Docket No. 09-1718 (issued March 5, 2010) (regarding factors to consider if a parking facility may 

be considered part of the employment premises). 
5

To properly apply the idiopathic fall exception to the general compensability created 

under the premises rule, two elements must be present: first, the fall must be caused by a 

personal, nonoccupational pathology, and second, there must be no contribution from the 

employment.13 OWCP has the burden of proof to establish existence of a personal, 

nonoccupational pathology. If the record does not establish the fall was due to an idiopathic 

condition, it must be considered as merely an unexplained fall, which is covered under FECA.14 

In his June 25, 2015 report, Dr. Bleazard described appellant’s fall as a syncopal episode. 

He noted that appellant was hyperglycemic when she reported to the emergency department and 

noted that she had a history of diabetes mellitus. Although Dr. Bleazard described the incident 

as syncopal, he noted that appellant was hyperglecemic, and indicated that she had a history of 

diabetes mellitus, he failed to provide an opinion regarding the cause of the fall. Furthermore, 

there is no evidence of a history of falling due to diabetes or a history of uncontrolled diabetes. 

The record also fails to establish a history of dizziness due to high and low blood sugar, as 

reported by the employing establishment in the Form CA-1. The mere fact that an employee has 

a preexisting medical condition, without supporting medical rationale, is not sufficient to 

establish that a fall is idiopathic.15 If the cause of the fall cannot be determined or the reason it 

occurred cannot be explained, then it is an unexplained fall and any resulting injury would be 

compensable.16 The Board finds that the evidence of record is not sufficient to meet OWCP’s 

burden of proof to establish the fall as idiopathic. 

Proceedings under FECA are not adversarial in nature and OWCP is not a disinterested 

arbiter. While the claimant has the burden to establish her claim, OWCP shares responsibility in 

the development of the evidence to see that justice is done.17 Accordingly, the case will be 

remanded to further develop the evidence and make appropriate fact findings with regards to the 

location, time, and circumstances surrounding appellant’s fall on June 24, 2015. If appellant’s 

fall is found to have occurred on the employment premises, OWCP should further develop the 

medical evidence with regard to whether the June 24, 2015 incident caused an injury. Following 

this and such further development as is deemed necessary, OWCP shall issue a de novo decision.

CONCLUSION 

The Board finds that the case is not in posture for decision. 

 13 Id. 

14 N.P., Docket No. 08-1202 (issued May 8, 2009). 

15 L.R., Docket No. 15-255 (issued April 1, 2015). 

16 Id. 

17 See K.C., Docket No. 08-2355 (issued May 15, 2009). 
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ORDER 

IT IS HEREBY ORDERED THAT the September 4, 2015 decision of the Office of 

Workers’ Compensation Programs is set aside and the case is remanded for further development 

consistent with this opinion. 

Issued: July 18, 2016 

Washington, DC 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board