United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

E.C., Appellant 

and 

DEFENSE LOGISTICS AGENCIES, 

Fort Belvoir, VA, Employer 

__________________________________________ 

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Docket No. 16-1334 

Issued: February 8, 2017 

Appearances: Case Submitted on the Record

Capp P. Taylor, Esq., for the appellant1

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

ALEC J. KOROMILAS, Alternate Judge 

JURISDICTION 

On June 14, 2016 appellant, through counsel, filed a timely appeal from a May 12, 2016 

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. 

ISSUE 

The issue is whether appellant met her burden of proof to establish a traumatic injury in 

the performance of duty on May 19, 2014. 

 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

FACTUAL HISTORY 

On May 29, 2014 appellant, then a 55-year-old supply systems analyst, filed a traumatic 

injury claim (Form CA-1) alleging that on May 19, 2014 she experienced dizziness, difficulty 

standing up, and throbbing in her head when her chair rolled back and the chair hit the top of her 

head. She explained that she was sitting in her chair and she bent over to tie her sneakers when 

the chair rolled onto plexiglass and flipped her onto the floor. Appellant related that she fell onto 

her hands and knees on the floor and the top part of the chair hit the back of her head. She 

stopped work on May 19, 2014. 

A May 29, 2014 accident incident report indicated that on May 19, 2014 appellant was 

sitting in her chair, leaning forward to tie her shoes, when she fell forward. She landed on the 

floor and the chair struck the back of her head. Appellant noted that she experienced dizziness 

and confusion. It was reported that a plastic floor mat was underneath her seat, which may have 

caused the chair to slip. Appellant’s supervisor removed the plastic floor mat and advised 

appellant to seek medical treatment in the emergency room. The accident report indicated that 

appellant was diagnosed with a head injury, dizziness, and hypoglycemia, which was a 

preexisting condition. 

Appellant was treated in the emergency room by Dr. Daniel E. Angeli, Board-certified in 

emergency medicine, who noted in hospital records dated May 19, 2014 that she was examined 

for complaints of head injury, dizziness, and hypoglycemia after a near syncopal episode at 

work. Dr. Angeli described that she leaned forward in her chair to tie her shoes when her chair 

slipped out from underneath her and the back of the chair hit her in the back of her head. He 

noted that appellant experienced pain in her knees, chest, and head, and headaches and dizziness. 

Dr. Angeli reviewed her medical history and conducted an examination. He reported that a 

computed tomography (CT) scan of the head revealed no acute traumatic injury. Dr. Angeli 

noted that appellant’s blood chemistry was abnormal and diagnosed headache, muscle pain, and 

possible hypoglycemia. He related that the “injury mechanism was a fall.” 

Dr. Sara S. Breeden, a Board-certified family practitioner also treated appellant and 

indicated in examination notes dated May 22 and 27, 2014 that appellant was examined for 

follow-up after being treated in the emergency room. She related that appellant fell down on the 

floor at work when she was bending over and that a chair hit her on the back of the head. 

Appellant experienced headaches, dizziness, abdominal pain, and sharp left arm and knee pain 

afterwards. Dr. Breeden mentioned that appellant’s sugar level was 114 when tested in the 

emergency room. She reviewed appellant’s history and reported that neurologically appellant 

was alert and oriented. Deep tendon reflexes were positive in all four extremities. Dr. Breeden 

diagnosed low blood sugar, unspecified hypertension, head injury, and abdominal pain. In work 

status notes, she requested that appellant be excused from work from May 19 to June 1, 2014. 

Appellant was treated by Dr. Richard E. Waller, a Board-certified neurologist, who 

indicated in progress notes dated June 11 to July 10, 2014 that he examined her for complaints of 

neurologic symptoms following a head injury. Dr. Waller related her history of injury regarding 

the chair roll and fall and noted that she immediately experienced headaches and dizziness and 

was transported to the emergency room. He related that since then appellant complained of daily 

headaches, stabbing pains in her scapula, arms, legs, feet, and stomach. Dr. Waller reviewed her 
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medical history and conducted a physical examination, which found that her range of motion of 

the neck was decreased in all directions. In a July 10, 2014 progress note, he related that a 

magnetic resonance imaging scan of the cervical spine revealed multilevel degenerative changes. 

Dr. Waller diagnosed postconcussion syndrome, cervical spondylosis, glucose intolerance, sleep 

apnea, and hypertension. In a June 18, 2014 work status note, he indicated that appellant could 

return to work half-days. 

On July 8, 2014 appellant was examined by Dr. Vicki B. Latham, a Board-certified 

internist, who reviewed appellant’s history of injury and provided physical examination findings. 

Dr. Latham diagnosed foot and knee pain. She noted that appellant could return to work on 

July 11, 2014. 

By letter dated July 18, 2014, a senior human resources (HR) specialist at the employing 

establishment requested that OWCP develop appellant’s traumatic injury claim. She asserted 

that appellant’s underlying, preexisting, or degenerative medical conditions may have 

contributed to her fall and should not be associated with the claim. The HR specialist listed the 

medical reports she requested OWCP review and noted that these specific records noted 

abnormal blood sugar and essential hypertension. She asked that OWCP review these medical 

records and determine whether appellant’s underlying medical conditions were related to 

appellant’s traumatic injury claim. 

Appellant received medical treatment from Dr. Howard F. Duke, a Board-certified 

podiatrist and foot surgeon, who related in examination notes dated August 7 and 11, 2014 that 

she complained of Achilles tendinitis, edema, ankle and heel pain, numbness, and burning in her 

feet. Dr. Duke related that she bent over in a chair at work to tie her shoes when the chair tipped 

over. Appellant landed on her hands and knees and was hit in the back of the head by the chair. 

Upon examination, Dr. Duke observed palpable dorsalis pedis and posterior tibial pulses and no 

apparent varicosities. He diagnosed pain in limb, fasciitis, tendinitis, Achilles pain, edema, 

hammertoe deformity, and neuropathy. Dr. Duke indicated that appellant would be unable to 

work from August 7 to 8, 2014 due to surgery. On August 7, 2014 appellant underwent rigid 

mallet toe deformity. 

In a September 15, 2014 note, Kenn Shirley, a hospital clinical care manager, indicated 

that appellant was admitted to the hospital on September 11, 2014 and was discharged on 

September 15, 2014. He related that she was not cleared for work until September 29, 2014. 

Dr. William C. Walker, Board-certified in physical medicine and rehabilitation, also 

treated appellant. In reports dated October 20 and November 17, 2014, he related her history of 

injury and discussed the medical treatment she received. Dr. Walker related that appellant 

currently complained of trouble with memory and emotions and was taking medication for 

depression. Upon neurological examination, he reported normal sensory and motor function. 

Deep tendon reflexes were positive. Dr. Walker diagnosed sleep apnea, depression, 

postconcussion syndrome, post-traumatic headache, and cognitive disorder symptoms. 

In an October 24, 2014 letter, Dr. Joy A. O’Grady, a clinical psychologist, reported that 

appellant was struck on the head at work on May 19, 2014 and described the medical treatment 

she received. She reported that, since the head injury, appellant had frequent headaches, was 
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forgetful, and was slower to process information. Dr. O’Grady conducted a neurological and 

psychological evaluation. She reported that appellant’s neuropsychological profile reflected a 

mix of strengths and weaknesses. Dr. O’Grady observed that simple cognitive processing speed 

and verbal fluency were within normal limits, but impairments were noted in learning and simple 

cognitive processing speed. She explained that appellant’s neuropsychological profile reflected 

weaknesses in memory and executive skills. Dr. O’Grady diagnosed postconcussion syndrome 

and adjustment disorder with mixed emotional features. 

In a letter dated December 22, 2014, OWCP informed appellant that her claim was 

initially accepted as a minor injury, but was now being reopened on the merits. It advised her 

that the medical evidence on the record was insufficient to establish that she sustained a 

diagnosed condition as a result of the May 19, 2014 employment incident. OWCP requested that 

appellant submit additional evidence to establish her claim. Appellant was afforded 30 days to 

submit the additional evidence. 

Dr. Breeden related in a January 21, 2015 note that she had treated appellant for an injury 

that occurred on May 19, 2014. She reiterated appellant’s history of injury and reported that 

appellant experienced symptoms of dizziness and headache. 

In a January 22, 2015 statement, an internal review supervisor at the employing 

establishment explained that on the morning of May 19, 2014 she was making copies when 

appellant walked by out of the office. When she asked appellant if she was okay, appellant told 

her that she was bending over in her chair to tie her shoes when the chair hit her in the back of 

the head. The supervisor advised appellant to sit down and instructed another employee to call 

emergency medical services. She reported that appellant was in and out of the office from May 

to June 2014. The supervisor noted that appellant still complained that she was not able to read 

documents or concentrate on any projects. 

On January 27, 2015 OWCP received a letter from an HR specialist at the employing 

establishment, requesting that it conduct a review of all the medical documentation submitted by 

appellant in order to determine if there was a causal relationship between the work-related 

incident and her diagnosed psychological conditions. The HR specialist asserted that she had 

some possible underlying, preexisting, or degenerative medical conditions, which may have 

contributed to her fall at work on May 19, 2014. He reported that the employing establishment 

was unaware of any possible connection between the head contusion suffered by appellant and 

her present memory loss or any psychological condition as a result of her falling out of the chair 

at work. The HR specialist noted that medical documentation seemed to indicate that she 

suffered from low blood sugar and hypertension. He explained that a witness was within close 

proximity to appellant when the alleged fall from chair occurred and the witness did not hear or 

see the fall. The HR specialist requested that OWCP review all the evidence and make a 

determination. 

A February 2, 2015 statement from appellant’s coworker related that she sat three 

cubicles over from appellant, which was less than 10 feet away, and did not hear or see appellant 

falling out of her chair. 

On February 19, 2015 appellant retired due to disability. 
5

OWCP denied appellant’s claim in a decision dated May 5, 2015. It found that the 

May 19, 2014 incident occurred as alleged and that she was diagnosed with postconcussion 

syndrome, low blood sugar, and hypertension. OWCP denied appellant’s claim, however, 

finding that the injury did not occur in the performance of duty because her fall was idiopathic 

and not related to factors of appellant’s employment. 

On April 25, 2016 OWCP received appellant’s request, through counsel, for 

reconsideration of her claim based on a new legal argument. Counsel asserted that OWCP erred 

because it did not consider whether certain objects involved in the event were factors of 

employment as required pursuant to Albert E. Hermann, Jr., 35 ECAB 167 (1983). He alleged 

explained that the wheeled desk chair and the vinyl chair mat contributed to the chair rolling 

backwards, which caused appellant to fall forward onto the floor. Counsel argued that the fact 

that her low blood sugar may have caused her to initially lose her balance did not detract from 

the fact that the desk chair and vinyl mat also contributed to the accident. He noted that 

appellant had identified factors of employment that contributed to the fall, and therefore, the 

claim should be found compensable. 

By decision dated May 12, 2016, OWCP denied modification of the May 5, 2015 denial 

decision. It found that counsel’s submission was insufficient to establish that appellant sustained 

a traumatic injury in the performance of duty. OWCP determined in its May 12, 2016 decision, 

that counsel did not demonstrate that any incidents or factors of employment intervened or 

contributed to her alleged injury other than an idiopathic fall. 

LEGAL PRECEDENT 

As a general rule, an injury is considered to occur in the course of employment if it 

occurs at a time when the employee may reasonably be stated to be engaged in her master’s 

business, at a place when she may reasonably be expected to be in connection with her 

employment and while she was reasonably fulfilling the duties of her employment or engaged in 

doing something incidental thereto.3 One exception to the general rule is if the injury was a 

result of an idiopathic fall.4

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

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

employee to collapse and 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 the coverage of FECA.5

 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 explained, does not establish 

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

 3 T.F., Docket No. 08-1256 (issued November 12, 2008); Roma A. Mortenson-Kindschi, 57 ECAB 418 (2006); 

Eugene G. Chin, 39 ECAB 598 (1988). 

4 Roger Williams, 52 ECAB 468 (2001). 

5 See Albert E. Hermann, Jr., 35 ECAB 167 (1983); Stanley H. Dunihue, Jr., Docket No. 05-1418 (issued 

September 16, 2005). 
6

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.6 To be considered an idiopathic fall, two elements must be 

present: a fall resulting from a personal, nonoccupational pathology, and no contribution from 

the employment.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

ANALYSIS 

The record of evidence supports that the May 19, 2014 incident occurred at a place where 

appellant was reasonably expected to be and took place while she was fulfilling her duties or was 

engaged in doing something incidental thereto. As such, the alleged injury occurred in the 

course of her employment and would be considered compensable under the general performance 

of duty rule.9

 

OWCP found that the alleged May 19, 2014 injury did not occur in the performance of 

duty because it resulted from an idiopathic fall. It determined that the medical evidence of 

record established that appellant suffered from low blood sugar and hypertension, which were 

preexisting conditions, and were not established as causally related to her employment. The 

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

As previously noted, OWCP bears the burden of proof to establish an idiopathic fall.10 In 

L.J.,11 the Board found that OWCP failed to prove that a fall was idiopathic in nature as the 

medical evidence did not establish that an employee’s fall was solely the result of her 

nonoccupational orthostatic hypotension condition. The Board determined that the medical 

evidence of record demonstrated that the employee’s employment activities of bending over and 

stooping down, at least partially, contributed to her falling at work. 

Similarly, in this case, the Board finds that the medical evidence of record fails to show 

that appellant’s fall was solely the result of a personal, nonoccupational pathology. Various 

medical records, including Dr. Angeli’s May 19, 2014 hospital records, Dr. Breeden’s May 22 

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

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

8 Jennifer Atkerson, 55 ECAB 317 (2004). 

9 See supra note 3. 

10 Id. 

11 Docket No. 08-1415 (issued December 22, 2008). 
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and 27, 2014 examination notes, Dr. Waller’s June 11 and July 10, 2014 reports, Dr. Duke’s 

August 7 and 11, 2014 reports, and Dr. Walker’s October 20 and November 17, 2014 reports all 

describe how appellant was bending over in her chair to tie her shoes when the chair slipped out 

from underneath her. Although the medical records also demonstrate that she suffered from 

preexisting low blood sugar, hypoglycemia, and hypertension, none of the physicians opined that 

the incident resulted from any of these preexisting conditions. The mere fact that an employee 

has a preexisting medical condition, without supporting medical rationale to establish that it was 

the cause of the employment incident, is insufficient to establish that a fall is idiopathic.12 The 

medical reports of record demonstrate that appellant was sitting on her chair at her desk in her 

cubicle at work and bent over to tie her shoes when the fall occurred. Therefore, while the 

reports are insufficient to meet her burden of proof to establish her claim, they raise an 

uncontroverted inference that employment factors contributed to the work incident on 

May 19, 2014.13 

Moreover, the Board notes that the factual evidence also supported that employment 

conditions contributed to appellant’s fall at work. In the Form CA-1 appellant attributed her fall 

off the chair to the fact that her wheeled chair rolled onto plexiglass and flipped. She did not 

allege that she fell because of dizziness but, instead, that she experienced dizziness, difficulty 

standing up, and throbbing in her head after the alleged fall occurred. The May 29, 2014 

accident/incident report furthermore supported appellant’s statement. The report noted that a 

plastic floor mat was underneath her wheeled chair and that it “may have caused the chair to 

slip.” Accordingly, the record does support that conditions of employment did contribute, at 

least partially, to appellant’s alleged fall on May 19, 2014.14 

If the record does not establish that a 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 preexisting and caused the fall.15 The 

Board finds that OWCP has failed to meet its burden to establish that appellant’s fall out of her 

chair was of an idiopathic nature with no contribution or intervention from employment factors.16 

The evidence of record is sufficient to require OWCP to further develop the medical evidence 

and the case record.17

Accordingly, the case will be remanded for OWCP to determine the nature and extent of 

any injury or disability that resulted from the March 19, 2014 fall. Following this and such 

further development deemed necessary, OWCP shall issue an appropriate de novo decision. 

 12 See Steven S. Saleh, 55 ECAB 169 (2003). 

13 See supra note 7. 

14 Id. 

15 Supra note 8. 

16 R.D., Docket No. 13-1854 (issued December 23, 2014). 

17 See Robert A. Redmond, 40 ECAB 796, 801 (1989). 
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CONCLUSION 

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

ORDER 

IT IS HEREBY ORDERED THAT the May 12, 2016 decision of the Office of 

Workers’ Compensation Programs is set aside and the case is remanded to OWCP for 

proceedings consistent with this opinion of the Board. 

Issued: February 8, 2017 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board