United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

T.R., Appellant 

and 

EQUAL EMPLOYMENT OPPORTUNITY 

COMMISSION, Memphis, TN, Employer 

__________________________________________ 

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Docket No. 16-0754 

Issued: October 17, 2016 

Appearances: Case Submitted on the Record

Appellant, pro se 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

ALEC J. KOROMILAS, Alternate Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On March 4, 2016 appellant filed a timely appeal of a December 31, 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 to consider the merits of the case. 

ISSUE 

The issue is whether appellant sustained a traumatic injury on November 3, 2014 causally 

related to the accepted employment incident. 

FACTUAL HISTORY 

On November 6, 2014 appellant, a 39-year-old paralegal specialist, filed a traumatic 

injury claim (Form CA-1), alleging that she sustained an injury on November 3, 2014 when she 

 1

 5 U.S.C. § 8101 et seq.
2

experienced an anxiety attack and fell to the floor, injuring her head, neck, back, and shoulder. 

She stopped work on November 3, 2014. 

Appellant asserted in a statement attached to the form that she experienced anxiety after 

being involved in a heated conversation with her supervisor, who was verbally abusive and 

physically intimidated her, and that she subsequently lost consciousness. She related that she 

was walking past her supervisor’s office when her supervisor called her name and told her to 

come into her office. The supervisor then told appellant that she understood that appellant was 

upset on Friday, and she then asked whether appellant was upset for having to take annual leave 

to attend continuing legal education (CLE) training. Appellant related that she replied that she 

did not know she had to take annual leave to attend the CLE training, but that she requested 

leave, as told. She asserted that her supervisor’s voice became loud and her tone became 

extremely harsh. Appellant was then told that she should have known because she attended CLE 

last year and was told that she needed to get permission to attend. She related that she told her 

supervisor that she remembered that she had to change her leave to administrative leave last year, 

and that she now knew the proper procedure and had complied. 

Appellant related that her supervisor became enraged and yelled, “leaving to attend a 

CLE without permission is like stealing time from the government.” She alleged that when she 

again defended her actions her supervisor stood up, moved from behind her desk, hovered over 

appellant yelling, “you learned nothing at the CLE that would be helpful to the employing 

establishment as a paralegal.” Appellant alleged that she began to cry and her supervisor 

screamed, “Why are you crying?” to which appellant responded “I’m a sensitive person.” 

When appellant asked her supervisor if she could leave the room and return to her office, 

the supervisor moved and stood in front of her office door and blocked the path, refusing to let 

appellant exit her office. Appellant alleged that she was standing while her supervisor ranted 

that she should not be crying and should not have been upset. She felt threatened and scared for 

her safety, she then lost consciousness and passed out and fell down hard on the floor. When 

appellant awakened she was lying on the floor with her entire body and head in excruciating 

pain. At that point someone called 911 and took her to the hospital in an ambulance. An 

incident report submitted with the claim noted that appellant passed out and fell to the floor on 

November 3, 2014. 

On December 12, 2014 OWCP advised appellant that it required factual and medical 

evidence to determine whether she was eligible for compensation benefits. It asked her to submit 

a comprehensive report from a treating physician describing her symptoms and the medical 

reasons for her condition, with an opinion as to whether her claimed condition was causally 

related to her federal employment. OWCP afforded appellant 30 days to submit this evidence. 

In a December 19, 2014 statement, appellant’s supervisor rebutted her allegations that she 

engaged in abusive conduct which caused appellant to experience anxiety and lose consciousness 

on November 3, 2014. She asserted that she was not responsible for appellant’s dropping to the 

floor in her office. The supervisor denied that she hovered over appellant, that she moved and 

stood in front of her door and blocked appellant’s path, refusing to allow her to exit her office, 

and denied that she yelled, shouted and screamed at appellant. She advised that there were three 

coworkers who were sitting close to her office who would have overheard her yelling, shouting, 
3

and screaming at appellant. The supervisor related that she had asked appellant to appear in her 

office to speak with her about three issues concerning her leave and attendance and office 

conduct. After discussing these three issues with appellant, appellant asked her supervisor 

whether she was finished, and she responded that she was. The supervisor denied appellant’s 

assertion that she moved and stood in front of her office door and blocked her path, refusing to 

let appellant exit her office. She related that after appellant left her office she heard her fall, 

went out to assist her, and then called 911 and waited for paramedics to attend to appellant. 

In a January 9, 2015 report, Dr. Henry Stamps, a specialist in internal medicine, noted 

that he had been treating appellant since November 5, 2014 for acute stress reaction and 

concussion following a syncope episode. He reported that the syncope occurred at work after 

appellant had a hostile encounter at work with her immediate supervisor. Dr. Stamps noted that 

when he first saw appellant on November 5, 2014 she was having trouble expressing herself 

because she was experiencing stress. He reported that she was in severe pain. Dr. Stamps 

prescribed pain medication and muscle relaxers. He asserted that appellant returned on 

November 11, 2014 because her condition had not greatly improved. Dr. Stamps adjusted her 

medication regimen and referred her to physical therapy for neck and back pain. He advised that 

despite undergoing physical therapy appellant returned for further treatment on November 25, 

2014, as she was still complaining of pain and headaches. Dr. Stamps opined that more leave 

time was warranted. He related that appellant had since recovered and had been able to return to 

work since December 18, 2014. 

By decision dated January 20, 2015, OWCP denied the claim, finding that the alleged 

incident occurred in the performance of duty and that appellant had been diagnosed with 

syncope, but that appellant failed to submit sufficient medical evidence to establish that the 

accepted incident caused her diagnosed condition. 

By letter dated September 18, 2015, appellant requested reconsideration of the 

January 20, 2015 decision. 

In an April 13, 2015 report, received by OWCP on September 29, 2015, Dr. Stamps 

advised that, after reviewing appellant’s medical records from her November 3, 2014 emergency 

room visit and his November 5, 2014 examination, he had diagnosed appellant with an acute 

stress reaction following a syncope in which she suffered a concussion. He reported that on 

November 3, 2014 appellant fainted, had an acute stress reaction and fell at work during a hostile 

confrontation from her supervisor. Dr. Stamps advised that syncope occurs under fear and 

emotional distress; appellant’s laboratory reports hours after she had a hostile confrontation at 

work showed that she was still under such stress that her heart rhythms displayed sinus 

tachycardia, nonspecific T-wave abnormalities, and an abnormal electrocardiogram upon first 

review; appellant also had poor R-wave progression. He opined that these findings revealed an 

acute stress reaction which could occur as a result of a hostile confrontation at work and from a 

traumatic fall. During the November 25, 2014 visit, Dr. Stamps advised her that her syncope 

was due to the acute stress reaction which occurred as a direct result from the hostile 

confrontation from her supervisor. He opined that the hostile confrontation placed appellant 

under fear and emotional distress which caused her syncope and an acute stress reaction and a 

concussion. 
4

By decision dated December 31, 2015, OWCP denied modification of the January 20, 

2015 decision. It found that Dr. Stamp’s reports were not based on an accurate history of injury 

as there were inconsistencies of record as to the events of November 3, 2014. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA2 has the burden of establishing that 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 injury was sustained in the performance of duty as alleged, 

and that any disability and/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 upon a traumatic injury or an 

occupational disease.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. 

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

experienced the employment incident at the time, place, and in the manner alleged.5

 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.6 The medical evidence required 

to establish causal relationship is usually rationalized medical 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 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.7

OWCP has the burden of proof to submit medical evidence showing the existence of a 

personal, nonoccupational pathology if it chooses to make a finding that a given fall is idiopathic 

in nature. The fact that the cause of a particular fall cannot be determined does not establish that 

it was due to an idiopathic condition and if the record does not establish a particular fall was due 

to an idiopathic condition, it must be considered as merely an unexplained fall, which is covered 

under FECA.8

 2

 5 U.S.C. § 8101 et seq. 

3 Joe D. Cameron, 41 ECAB 153 (1989); Elaine Pendleton, 40 ECAB 1143 (1989). 

4

 Victor J. Woodhams, 41 ECAB 345 (1989). 

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

6 Id. For a definition of the term “injury,” see 20 C.F.R. § 10.5(a)(14). 

7 Id.

8 See T.S., Docket No. 26-0113 (issued May 3, 2016). 
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ANALYSIS 

OWCP accepted that an incident occurred on November 3, 2014 and that appellant fell; it 

did not accept that she sustained syncope causally related to employment factors. The Board 

finds that the case is not in posture for decision. 

While OWCP initially found in the January 20, 2015 decision that the incident occurred as 

alleged, it also found that the medical evidence of record did not establish that the accepted 

incident caused appellant’s diagnosed condition. Appellant thereafter submitted additional reports 

from Dr. Stamps which were generally supportive of appellant’s claim. OWCP then denied the 

claim finding that Dr. Stamps’ reports were not based on an accurate history of injury as there were 

inconsistencies in the record as to the incident of November 3, 2014. It however never made any 

findings as to the nature and circumstances of the accepted incident, and did not explain the 

inconstancies of record. The Board also notes that OWCP never evaluated whether appellant’s fall 

on November 3, 2014 was an idiopathic or unexplained fall.9

Appellant submitted reports from Dr. Stamps, who opined that the syncope occurred at 

work after she had a hostile encounter at work with her immediate supervisor. Dr. Stamps noted 

that when he first saw appellant on November 5, 2014 she was having trouble expressing herself 

because she was experiencing stress. He reported that she was in severe pain, he prescribed pain 

medication and muscle relaxers. Dr. Stamps asserted that appellant returned on November 11, 

2014 because her condition had not greatly improved. He adjusted her medication regimen and 

referred her to physical therapy for neck and back pain. Dr. Stamps advised that despite 

undergoing physical therapy appellant returned for further treatment on November 25, 2014, as 

she was still complaining of pain and headaches. He opined that more leave time was warranted. 

Dr. Stamps related that appellant had since recovered and had been able to return to work since 

December 18, 2014. In his April 13, 2015 report, he advised that, after reviewing appellant’s 

medical records from her November 3, 2014 emergency room visit and his November 5, 2014 

examination, he had diagnosed appellant with an acute stress reaction following a syncope in 

which she suffered a concussion. Dr. Stamps reported that on November 3, 2014 appellant 

fainted, had an acute stress reaction and fell at work during a hostile confrontation from her 

supervisor. He advised that syncope occurs under fear and emotional distress; appellant’s 

laboratory reports hours after she had a hostile confrontation at work showed that she was still 

under such stress that her heart rhythms displayed sinus tachycardia, nonspecific T-wave 

abnormalities, and an abnormal electrocardiogram upon first review; appellant also had poor Rwave progression. Dr. Stamps opined that these findings revealed an acute stress reaction which 

could occur as a result of a hostile confrontation at work and from a traumatic fall. During 

November 25, 2014 visit, he advised her that her syncope was due to the acute stress reaction 

which occurred as a direct result from the hostile confrontation from her supervisor. Dr. Stamps 

opined that the hostile confrontation placed appellant under fear and emotional distress which 

caused her syncope and an acute stress reaction and a concussion. 

Proceedings under FECA are not adversarial in nature nor is OWCP a disinterested 

arbiter. While the claimant has the burden to establish entitlement to compensation, OWCP 

 9 See L.R., Docket No. 15-0255 (issued April 1, 2015). 
6

shares responsibility in the development of the evidence to see that justice is done.10 While 

Dr. Stamp’s reports do not contain sufficient rationale to discharge appellant’s burden of proving 

by the weight of the reliable, substantial, and probative evidence that her syncope condition and 

were caused by the accepted employment incident, his reports raise an inference of causal 

relationship sufficient to require further development of the case record by OWCP.11

If however 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. The 

burden of proof is on OWCP to establish that the fall was idiopathic.12

On return of the case record OWCP shall prepare a statement of accepted facts and refer 

appellant to a second opinion physician to determine whether her interaction with her supervisor 

on November 3, 2014 caused a syncopal episode, fall and resulting injuries. In the alternative, 

the second opinion physician should be asked for an opinion as to whether appellant’s fall was 

idiopathic or unexplained in nature. After such further development as necessary, OWCP shall 

issue a de novo decision. 

CONCLUSION 

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

 10 William J. Cantrell, 34 ECAB 1223 (1983). See also J.S., Docket No. 13-2022 (issued July 28, 2014). 

11 See John J. Carlone, supra note 5; Horace Langhorne, 29 ECAB 820 (1978). 

12 Supra note 9. 
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ORDER 

IT IS HEREBY ORDERED THAT the December 31, 2015 decision of the Office of 

Workers’ Compensation Programs is set aside and this case is remanded for further proceedings 

consistent with this decision. 

Issued: October 17, 2016 

Washington, DC 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board