United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

L.B., Appellant 

and 

DEPARTMENT OF THE ARMY, 

Fort Bragg, NC, Employer 

__________________________________________ 

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Docket No. 15-761 

Issued: June 4, 2015 

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

COLLEEN DUFFY KIKO, Judge 

ALEC J. KOROMILAS, Alternate Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On February 18, 2015 appellant, through counsel, filed a timely appeal from a January 6, 

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 the case. 

ISSUE 

The issue is whether appellant’s collapse at work and cardiac arrest on October 16, 2012 

was in the performance of duty within the meaning of FECA. 

On appeal counsel asserts that in its January 6, 2015 decision OWCP improperly 

concluded that an expert opinion regarding appellant’s cardiac arrest was equivocal. 

 1

 5 U.S.C. §§ 8101-8193. 
2

FACTUAL HISTORY 

This case has previously been before the Board. In a March 21, 2014 decision, the Board 

found that appellant had not sustained an injury in the performance of duty on October 16, 2012 

and that she had not established a stress-related condition due to the accepted employment factor, 

that her job duties as a dispatcher included interacting with the public in emergency and stress 

situations.2 

On November 18, 2014 appellant, through counsel, requested reconsideration and 

submitted an undated correspondence report from Dr. Rommel, an attending Board-certified 

internist.3

 In that report he stated that he had been treating appellant since October 17, 2012 

following her cardiac arrest at work. Dr. Rommel noted that after testing she was found to have 

a prolonged QT and genetic testing demonstrated a mutation consistent with congenital long QT 

syndrome. He advised that the mutation was associated with increased cardiac events, especially 

with exercise and auditory stimulation. Dr. Rommel concluded that it was reasonable to assume 

that appellant’s cardiac arrest was due to an undiagnosed genetic abnormality, and that “her 

arrest could have come from an auditory stimulation while at work.” He advised that she 

remained at increased risk for a cardiac event due to her genetic condition. 

In a merit decision dated January 6, 2015, OWCP found Dr. Rommel’s opinion 

speculative and denied modification of prior decisions. 

LEGAL PRECEDENT 

It is a general rule that where an injury arises in the course of employment, occurs within 

the period of employment, at a place where the employee reasonably may be and takes place 

while the employee is fulfilling her duties or is engaged in doing something incidental thereto, 

the injury is compensable unless it is established to be within an exception to the general rule. 

One of the exceptions to the general rule is an idiopathic fall.4 

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 employment -- is not within coverage of FECA. Such an injury does not arise out of 

a risk connected with the employment and is, therefore, not compensable. However, the fact that 

the cause of a particular fall cannot be ascertained or that the reason it occurred cannot be 

 2

 Docket No. 13-1640 (issued March 21, 2014). On October 16, 2012 appellant, a public safety dispatcher, fell 

while walking from the break room and went into cardiac arrest. She was resuscitated and transported to Womack 

Army Medical Center where she was stabilized. On October 17, 2012 appellant was transferred to University of 

North Carolina Health Care, where she was diagnosed with long QT syndrome. She was discharged on 

October 25, 2012. Appellant was treated by Dr. John Rommel, a Board-certified internist. Dr. Rommel advised that 

appellant’s genetic cardiac condition could be triggered by stress and being startled. 

3

 Appellant had also submitted medical evidence describing a left shoulder and left knee condition, not relevant to 

the instant appeal. 

4 Roger Williams, 52 ECAB 468 (2001). 
3

explained, does not establish that it was due to an idiopathic condition. 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.5 To properly apply the idiopathic fall exception to the premises rule, 

there must be two elements present: a fall resulting from a personal, nonoccupational pathology, 

and no contribution from the employment.6 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. 

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.7 

ANALYSIS 

In its March 21, 2014 decision, the Board found that appellant had failed to establish a 

stress-related condition causally related to the accepted factor of employment.8

 Because 

appellant had not provided evidence regarding this issue with the November 18, 2014 

reconsideration request, and because OWCP had not addressed it in the January 6, 2015 decision, 

the matter is res judicata and not subject to further review by the Board absent further review by 

OWCP.9 The remaining issues remain before the Board. 

The Board finds that appellant failed to establish that her collapse on October 16, 2012 at 

work were in the performance of duty within the meaning of FECA. In the report submitted on 

reconsideration, Dr. Rommel found that appellant had genetic markers consistent with congenital 

long QT syndrome and that this condition is associated with increased incidence of cardiac 

events. He went on to surmise that appellant’s cardiac arrest was due to an undiagnosed genetic 

abnormality and added that it was “reasonable that her arrest could have come from an auditory 

stimulation at work.” This supposition is insufficient to meet her burden of proof. First, 

Dr. Rommel couched his opinion in speculative terms, and the opinion of a physician supporting 

causal relationship must not be speculative or equivocal. To be probative, an opinion should be 

expressed in terms of a reasonable degree of medical certainty.10 Second, the record contains no 

evidence that at the time of appellant’s cardiac arrest on October 16, 2012 she had been 

subjected to any auditory stimulus. In fact, the witness statements indicate that she was walking 

from the break room when she collapsed.11 

 5 M.M., Docket No. 08-1510 (issued November 25, 2008). 

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

7 Ricky S. Storms, 52 ECAB 349 (2001). 

8 Supra note 2. 

9 David E. Newman, 48 ECAB 305 (1997); Hugo A. Mentink, 9 ECAB 628 (1958). A decision of the Board is 

final upon the expiration of 30 days from the date of the decision. 20 C.F.R. § 501.6(d). 

10 Supra note 8. 

11 Supra note 2. 
4

Dr. Rommel’s opinion lacks the probative value to establish that a work factor caused 

appellant’s collapse and cardiac arrest on October 16, 2012. Moreover, there is no indication 

that appellant struck anything while falling. Her fall on October 16, 2012 is idiopathic and 

therefore noncompensable. 

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 did not sustain an injury in the performance of duty on 

October 16, 2012. 

ORDER 

IT IS HEREBY ORDERED THAT the January 6, 2015 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: June 4, 2015 

Washington, DC 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board