United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

C.F., Appellant 

and 

DEPARTMENT OF THE ARMY, TANKAUTOMOTIVE & ARMAMENTS COMMAND, 

Fort Benning, GA, Employer 

__________________________________________ 

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Docket No. 15-738 

Issued: June 18, 2015 

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On February 17, 2015 appellant, through counsel, filed a timely appeal from the 

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 to review the merits of this case. 

ISSUE 

The issue is whether appellant met her burden of proof to establish an injury causally 

related to a June 13, 2013 work incident. 

FACTUAL HISTORY 

On June 19, 2013 appellant, a 46-year-old tools and parts attendant, filed a traumatic 

injury claim alleging that she injured her left ankle and tail bone in the performance of duty 

 1

 5 U.S.C. § 8101 et seq.
2

when she tripped over a pallet and fell on June 13, 2013. She stopped work the following day 

and went to the emergency room where she saw a physician assistant. The physician assistant 

diagnosed a fractured left ankle. Appellant was released to light duty on June 18, 2013. 

In a decision dated February 28, 2014, OWCP denied appellant’s traumatic injury claim. 

It accepted that the June 13, 2013 work incident occurred as alleged, but found that appellant 

failed to submit medical evidence establishing a diagnosis causally related to the work incident. 

On February 27, 2014 Dr. Deanna M. del Mazo, an internist, requested that appellant be 

allowed to wear prescribed orthotic devices or shoe gear for treatment of her fractured foot. 

Appellant, through counsel, on March 27, 2014 requested a telephonic hearing before an 

OWCP hearing representative. 

During the hearing on October 17, 2014, appellant’s counsel argued that the timeline, 

along with appellant’s testimony and the medical records, showed causal relationship. Appellant 

was in a lot of pain after she fell, her tailbone more so than her left ankle. She told a coworker 

what happened. Appellant finished her shift, took a van pool home, and took medication. When 

she awoke the next morning she could barely climb out of bed because her tailbone hurt so 

much, and her left ankle was black and blue and swollen. Appellant went to the emergency 

room. It was later found that she had a left ankle fracture. Appellant wore a soft cast and walked 

around on crutches. Nothing more could be done for her fractured tailbone. 

In a decision dated January 6, 2015, an OWCP hearing representative affirmed the 

February 28, 2014 denial of appellant’s traumatic injury claim. He found that no physician had 

provided an opinion explaining how the June 13, 2013 work incident caused a diagnosed medical 

condition. The hearing representative found that the timeline of injury alone was insufficient to 

establish a work-related injury. 

On appeal, appellant’s counsel again argues the timeline of events: “How could claimant 

sustain her injury in any manner other than alleged? The claimant has sustained her burden of 

proof.” 

LEGAL PRECEDENT 

FECA provides compensation for the disability of an employee resulting from personal 

injury sustained while in the performance of duty.2

 An employee seeking benefits under FECA 

has the burden of proof to establish the essential elements of his or her claim. When an 

employee claims that he or she sustained an injury in the performance of duty, he or she must 

submit sufficient evidence to establish that he or she experienced a specific event, incident, or 

exposure occurring at the time, place, and in the manner alleged. He or she must also establish 

that such event, incident, or exposure caused an injury.3

 2

 5 U.S.C. § 8102(a). 

3 John J. Carlone, 41 ECAB 354 (1989). 
3

Causal relationship is a medical issue,4 and the medical evidence generally required to 

establish causal relationship is rationalized medical opinion evidence. The opinion of the 

physician must be based on a complete factual and medical background of the claimant,5

 must be 

one of reasonable medical certainty,6

 and must be supported by medical rationale explaining the 

nature of the relationship between the diagnosed condition and the established incident or factor 

of employment.7

A physician assistant is not considered a “physician” within the meaning of FECA and is 

therefore not competent to give a medical opinion.8

ANALYSIS 

OWCP accepts that appellant tripped over a pallet and fell at work on June 13, 2013. 

Appellant has therefore established that a specific event, incident, or exposure occurring at the 

time, place, and in the manner alleged. The question that remains is whether the accepted work 

incident caused a fracture of her left ankle and tailbone. 

The question of causal relationship is a medical issue that usually requires reasoned 

medical opinion for resolution. This evidence should be obtained from a physician who has 

examined or treated the claimant for the condition for which compensation is claimed.9

 There is 

no reasoned medical opinion in appellant’s case. Dr. del Mazo, the internist, confirmed that 

appellant had a fractured foot, but she made no attempt to connect this condition to what 

happened on June 13, 2013. On its face, then, the medical opinion evidence is insufficient to 

establish the critical element of causal relationship. 

OWCP recognizes, however, that a medical opinion on causal relationship is not required 

in every case. If all of the following criteria are satisfied, a claim may be accepted without a 

medical report addressing causal relationship: (1) The condition reported is a minor one which 

can be identified on visual inspection by a lay person (e.g., burn, laceration, insect sting or 

animal bite); (2) The injury was witnessed or reported promptly, and no dispute exists as to the 

fact of injury; and (3) No time was lost from work due to disability.10

 4 Mary J. Briggs, 37 ECAB 578 (1986). 

5 William Nimitz, Jr., 30 ECAB 567, 570 (1979). 

6 See Morris Scanlon, 11 ECAB 384, 385 (1960). 

7 See William E. Enright, 31 ECAB 426, 430 (1980). 

8 Guadalupe Julia Sandoval, 30 ECAB 1491 (1979); see 5 U.S.C. § 8101(2) (the term “physician” includes 

surgeons, podiatrists, dentists, clinical psychologists, optometrists, chiropractors and osteopathic practitioners within 

the scope of their practice as defined by state law). 

9

 Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.805.3 (January 2013). 

10 Id. at Chapter 2.805.c.3. 
4

Appellant’s injury was not a minor condition that could be identified on visual inspection 

by a lay person. It appears that she lost at least one day from work as a result of the claimed 

injury. Appellant stopped work on June 14, 2013. She was released to light duty on 

June 18, 2013. As all three criteria do not apply to appellant’s case, a medical report addressing 

causal relationship is required, notwithstanding the relative circumstances of her case. 

Because appellant has not submitted a physician’s opinion on the critical issue of causal 

relationship, the Board finds that she has not met her burden of proof to establish that the 

June 13, 2013 work incident caused an injury. The Board will therefore affirm OWCP’s 

January 6, 2014 decision denying her traumatic injury claim. 

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 has not met her burden to establish an injury causally 

related to a June 13, 2013 work incident. 

ORDER 

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

Workers’ Compensation Programs is affirmed. 

Issued: June 18, 2015 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board