United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

E.W., Appellant 

and 

DEPARTMENT OF VETERANS AFFAIRS, 

DAYTON VETERANS MEDICAL CENTER, 

Dayton, OH, Employer 

__________________________________________ 

) 

) 

) 

) 

) 

) 

) 

) 

) 

Docket No. 17-0069 

Issued: May 23, 2017 

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 

COLLEEN DUFFY KIKO, Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On October 17, 2016 appellant filed a timely appeal of a June 28, 2016 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 this case. 

ISSUE 

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

performance of duty. 

FACTUAL HISTORY 

On May 16, 2016 appellant, then a 70-year-old part-time housekeeping aid, filed a 

traumatic injury claim (Form CA-1), alleging that, during a fire drill, on February 10, 2016 a 

 1

 5 U.S.C. § 8101 et seq. 
2

nurse pushed his housekeeping cart out of the hallway and it ran over his feet. He also indicated 

that his fingers and thumb were smashed into the glass door. Appellant experienced swelling of 

the bilateral feet, left hand, fingers, and thumb. He returned to regular duty on 

February 24, 2016, but stopped work on March 2, 2016. The employing establishment indicated 

that appellant was in the performance of duty when the claimed injury occurred. 

By letter dated May 19, 2016, OWCP advised appellant of the type of medical and 

factual evidence needed to establish his claim, particularly requesting that appellant submit a 

physician’s reasoned opinion addressing the relationship between his claimed condition and the 

employment incident. It also requested that appellant further describe how his claimed injury 

occurred. In a letter of the same date, OWCP requested that the employing establishment 

comment. 

In a February 24, 2016 on-the-job injury and illness report, appellant indicated that on 

February 10, 2016, while he was cleaning a room on 3D--South, a code red was alerted. Before 

he could return his mop to the bucket, one of the nurses shoved his housekeeping cart back with 

great force, causing the wheels to run over his feet. He reported swelling of his feet. 

A February 24, 2016 employing establishment medical record from Dr. William D. 

Gould, Board-certified in emergency medicine, indicated that on February 17, 2016 appellant 

reported mopping a patient’s room when a fire alarm went off. Appellant noted that, as he 

entered the hallway, someone pushed his cleaning cart, which ran over the top of his feet. He 

noticed swelling extended all the way up to his knee. Dr. Gould noted physical findings of scaly 

and ashy colored feet and left lateral ankle swelling. He diagnosed possible contusion to the top 

of both feet. Dr. Gould returned appellant to full duty that day without restrictions. On March 2, 

2016 he noted that appellant complained of pain over the dorsal of his feet caused by a cart 

rolling over his feet on February 17, 2016. Dr. Gould noted pain and edema in appellant’s legs, 

hoarseness, shortness of breath, blood in his mucous, no swelling over the dorsum of the feet, 

and palpable tenderness over the feet. He diagnosed residual discomfort of the feet, shortness of 

breath, and possible pneumonia. Dr. Gould took appellant off duty. A March 2, 2016 x-ray of 

the feet revealed no acute fracture in either foot, but bipartite configuration of the hallux and 

tibial sesamoid bilaterally, which could represent a congenital etiology rather than an 

unincorporated old fracture, and small bilateral calcaneal enthesophytes. 

In notes dated March 8 and 14, 2016, Dr. Gould indicated speaking with appellant by 

telephone who reported coughing, blood in his mucous, and swelling of his left arm. On April 7, 

2016 he noted treating appellant in follow up after he had been discharged from a hospital on 

April 5, 2016 for treatment of left arm deep vein thrombosis (DVT). On May 19, 2016 

Dr. Gould noted findings that included no palpable edema over the feet, no palpable pain over 

dorsum of the feet where the cart rolled over them, no pain while walking, and no gait 

abnormality. Diagnoses included status post on-the-job injury February 10, 2016 and residual 

left arm swelling from DVT. Dr. Gould indicated that there appeared to be no problem with 

appellant’s feet from the previous injury of February 10, 2016. That injury was resolved, and 

was not related to the DVT hospitalization. 

The employing establishment submitted a January 13, 2016 report from Dr. Vaskar 

Mukerji, a Board-certified cardiologist, who performed a right and left heart catheterization and 
3

a coronary angiography. In a discharge summary dated January 14, 2016, Dr. Ashish Mahajan, a 

Board-certified internist, noted that appellant was admitted from January 13 to 14, 2016 with a 

principal discharge diagnosis of single vessel coronary artery disease (CAD), severe 

cardiomyopathy and pulmonary hypertension. 

In a March 29, 2016 report, Dr. Rebecca Tobias, a Board-certified internist, noted that 

appellant presented with left arm swelling and was found to have acute DVT and mild chronic 

heart failure. In a March 30, 2016 report, she noted continued left arm swelling. Appellant 

reported being injured at work when something ran over his left lower extremity and arm. He 

was hospitalized and diagnosed with acute upper extremity DVT. Dr. Tobias’ diagnoses 

included diagnosed acute upper extremity DVT, possibly provoked given recent history of injury 

to his arm and leg, and left leg swelling with recent injury. In an April 4, 2016 discharge 

summary, she noted that appellant was admitted from March 29 to April 4, 2016 for left upper 

extremity swelling. Appellant reported injuries to his feet on February 17, 2016 when a cart at 

work ran into him. Dr. Tobias noted cardiovascular and pulmonary diagnoses. 

A March 29, 2016 report from Dr. Garietta N. Falls, a Board-certified vascular surgeon, 

noted appellant’s cardiovascular treatment. Appellant reported doing well until March 17, 2016 

when his feet were run over by a work cart and he developed left upper extremity swelling. 

Dr. Falls noted findings relative to appellant’s DVT. She diagnosed past medical history of 

hypertension, chronic heart failure, recent onset of left upper extremity swelling, and unprovoked 

DVT of the left upper extremity. 

In an April 13, 2016 e-mail, an employing establishment human resources specialist, 

requested information from Dr. Tobias on appellant’s treatment. On April 13, 2016 Dr. Tobias 

indicated that she had not treated appellant for a work injury. She noted treating appellant for a 

new arm swelling a couple of weeks earlier. Dr. Tobias diagnosed left arm DVT. She indicated 

that she initially considered that the prior injury may have been a risk factor for developing a 

DVT, but a consulting hematologist did not feel that the DVT in the arm could have been related 

to an injury that occurred almost two months prior. Appellant was diagnosed with unprovoked 

left arm DVT. 

On April 25, 2016 Dr. Perry G. Nystrom, a Board-certified anesthesiologist and internist, 

treated appellant in follow up for chronic obstructive pulmonary disease (COPD) and hemoptysis 

during an inpatient stay for left arm DVT in March 2016. He noted appellant’s cardiovascular 

and pulmonary findings and diagnoses. 

On May 16, 2016 Ms. Mohamed requested that the employing establishment provide a 

fire drill roster. The employing establishment’s safety service provided a February 10, 2016 fire 

drill log which indicated that on February 10, 2016 a fire drill was conducted in building 330 at 

1700 hours. The fire alarm and drill participation log was signed by appellant. 

The employing establishment submitted an incident report dated May 17, 2016 signed by 

appellant’s supervisor, who noted that on February 10, 2016 appellant was working on the SAM 

3 South Unit cleaning. A fire alarm drill was conducted around 5:00 p.m. at which time 

appellant had his cart half-in and half-out of the room he was cleaning. Another staff member 

pushed the cleaning cart back into the room and the cart ran over appellant’s feet. Appellant 
4

reported that while trying to leave the room both his hands were smashed into the glass doors of 

the patient’s room. 

In a letter dated May 24, 2016, Ms. Mohamed indicated that appellant initially reported 

his work injury occurred on February 17, 2016 during a fire drill; however, an incident report 

prepared by appellant’s supervisor, confirmed the date of injury as February 10, 2016. 

Additionally, records received from the employing establishment’s Safety Service fire drill 

participation log confirmed that the fire drill occurred on February 10, 2016. 

In a June 28, 2016 decision, OWCP denied appellant’s claim, finding that the evidence of 

record did not support that the injury or events occurred as alleged. 

LEGAL PRECEDENT 

 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 filed within the applicable time 

limitation 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 is causally related to 

the employment injury. 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.2

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

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

There are two components involved in establishing 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. Second, the employee must submit medical evidence 

to establish that the employment incident caused a personal injury.3

An employee’s statement that an injury occurred at a given time and in a given manner is 

of great probative value and will stand unless refuted by strong or persuasive evidence.4 

Moreover, an injury does not have to be confirmed by eyewitnesses. The employee’s statement, 

however, must be consistent with the surrounding facts and circumstances and her subsequent 

course of action. An employee has not met his or her burden in establishing the occurrence of an 

injury when there are such inconsistencies in the evidence as to cast serious doubt upon the 

validity of the claim. Circumstances such as late notification of injury, lack of confirmation of 

injury, continuing to work without apparent difficulty following the alleged injury, and failure to 

obtain medical treatment may, if otherwise unexplained, cast doubt on an employee’s statement 

in determining whether a prima facie case has been established.5

 2 Gary J. Watling, 52 ECAB 357 (2001). 

3

 T.H., 59 ECAB 388 (2008). 

4 R.T., Docket No. 08-408 (issued December 16, 2008); Gregory J. Reser, 57 ECAB 277 (2005). 

5 Betty J. Smith, 54 ECAB 174 (2002); L.D., Docket No. 16-0199 (issued March 8, 2016). 
5

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 

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

specific employment factors identified by the claimant.6

ANALYSIS 

OWCP denied appellant’s claim finding that he failed to establish that the claimed 

incident occurred as alleged. There is no dispute that appellant was actually performing the job 

of a housekeeping aid on February 10, 2016, the date which he alleges an injury.7 Specifically, a 

May 17, 2016 employing establishment incident report signed by appellant’s supervisor noted 

that on February 10, 2016 appellant was working in the SAM 3 South Unit cleaning unoccupied 

patients’ rooms. A fire alarm drill was conducted around 5:00 p.m. at which time appellant had 

his cart half-in and half-out of the room when a staff member pushed the cleaning cart back into 

the room, running over appellant’s feet. 

A February 10, 2016 employing establishment fire drill log confirms that on February 10, 

2016 a fire drill was conducted in building 330 at 1700 hours and that appellant was a 

participant. Additionally, an on-the-job injury and illness report dated February 24, 2016 

prepared by appellant indicated that while he was finishing cleaning a room on 3D--South, a 

code red was alerted. Before he could place his mop into the mop bucket, one of the nurses 

shoved his cart back with great force causing the wheels to run over his feet. The Board finds 

that the evidence is undisputed that on February 10, 2016 appellant was performing his work 

duties as a housekeeping aid in the South Unit when a fire drill occurred and his cleaning cart 

was pushed and ran over his feet. The evidence, however, does not substantiate that appellant 

injured his arm or hand. The most contemporaneous medical report from Dr. Gould, dated 

February 24, 2016, makes no reference to a hand or arm condition. 

The Board finds, however, that appellant failed to submit sufficient medical evidence to 

establish that the February 10, 2016 work incident caused or aggravated his bilateral foot and left 

arm conditions. 

On February 24, 2016 Dr. Gould indicated that on February 17, 2016 appellant reported 

mopping a patient’s room when a fire drill occurred and his cleaning cart was pushed and ran 

over the top of both of his feet. He diagnosed “possible contusion” to the top of bilateral feet. 

At best, this report provides only speculative support for causal relationship as the physician 

qualifies his support by diagnosing “possible” contusion to the top of the feet. Dr. Gould 

provided no medical reasoning to support his opinion on causal relationship.8

 He also reported 

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

7

 The Board notes that some documents indicate that the claimed injury occurred on February 17, 2016. 

However, as noted, the employing establishment human resource specialist confirmed through a fire drill log that the 

fire drill was conducted on February 10, 2016. 

8

 Medical opinions that are speculative or equivocal in character are of diminished probative value. D.D., 57 

ECAB 734 (2006). 
6

an inaccurate date of injury.9

 Therefore, this report is insufficient to meet appellant’s burden of 

proof. 

On March 2, 2016, Dr. Gould noted that appellant presented with pain over the dorsal of 

both feet caused by a cart rolling over them on February 17, 2016. He diagnosed residual 

discomfort of the feet due to the February 17, 2016 incident. In a report dated May 19, 2016, 

Dr. Gould diagnosed status post on-the-job injury. However, he appears merely to be repeating 

the history of injury as reported by appellant without providing his own opinion as to whether 

appellant’s condition was work related. To the extent that Dr. Gould is providing his own 

opinion, he failed to provide a rationalized opinion regarding the causal relationship between 

appellant’s bilateral foot conditions and the February 10, 2016 employment incident.10 

In reports dated March 29 to April 4, 2016, Dr. Tobias treated appellant for left upper 

extremity edema. Appellant presented with left upper extremity swelling and reported being 

injured at work when a cart ran over his feet on February 17, 2016. In a March 30, 3016 report, 

Dr. Tobias diagnosed acute upper extremity DVT and left lower extremity swelling with recent 

injury. On April 13, 2016 she indicated that appellant’s prior injury to his arm and legs was not 

a risk factor for DVT. Dr. Tobias indicated that the left arm DVT was not related to the claimed 

work injury. These records from Dr. Tobias do not support that the work incident caused or 

aggravated any diagnosed medical condition.11 Rather, Dr. Tobias concluded that the DVT in 

the left arm was unrelated to the work injury that occurred in February 2016. 

A March 29, 2016 report from Dr. Falls noted diagnoses and advised that appellant 

reported doing well until March 17, 2016 when his feet were run over by a work cart and he 

developed left upper extremity swelling. As noted above, Dr. Falls is repeating the history of 

injury as reported by appellant without providing his own rationalized opinion regarding the 

causal relationship between appellant’s conditions and the work incident believed to have caused 

or contributed to such condition.12 The probative value of his report is further diminished 

because it refers to an inaccurate injury date.13 Therefore, this report is insufficient to meet 

appellant’s burden of proof. 

The remainder of the medical evidence fails to provide an opinion on causal relationship 

between appellant’s work incident and his diagnosed left arm and bilateral foot condition. For 

this reason, this evidence is not sufficient to meet appellant’s burden of proof.14

 9 See Leonard J. O’Keefe, 14 ECAB 42, 48 (1962) (where the Board held that medical opinions based upon an 

incomplete history or which are speculative or equivocal in character have little probative value). 

10 A.D., 58 ECAB 149 (2006) (medical evidence which does not offer any opinion regarding the cause of an 

employee’s condition is of limited probative value on the issue of causal relationship). 

11 Jimmie H. Duckett, 52 ECAB 332 (2001); Franklin D. Haislah, 52 ECAB 457 (2001) (medical reports not 

containing rationale on causal relationship are entitled to little probative value). 

12 Supra note 10. 

13 Supra note 9. 

14 Supra note 10. 
7

An award of compensation may not be based on surmise, conjecture, or speculation. 

Neither the fact that appellant’s condition became apparent during a period of employment nor 

the belief that his condition was caused, precipitated, or aggravated by his employment is 

sufficient to establish causal relationship. Causal relationship must be established by 

rationalized medical opinion evidence.15 As appellant failed to submit such evidence, he has not 

met his burden of proof. 

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 meet his burden of proof to establish an injury 

causally related to a February 10, 2016 employment incident. 

ORDER 

IT IS HEREBY ORDERED THAT the June 28, 2016 decision of the Office of 

Workers’ Compensation Programs is affirmed, as modified. 

Issued: May 23, 2017 

Washington, DC 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board 

 15 See Dennis M. Mascarenas, 49 ECAB 215 (1997).