United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

B.L., Appellant 

and 

DEPARTMENT OF JUSTICE, BUREAU OF 

PRISONS, Beaumont, TX, Employer 

__________________________________________ 

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Docket No. 16-0358 

Issued: July 15, 2016 

Appearances: Case Submitted on the Record

Appellant, pro se 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On December 21, 2015 appellant filed a timely appeal of a November 30, 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.2

ISSUE 

The issue is whether appellant met his burden of proof to establish an employmentrelated injury on October 17, 2015, as alleged. 

 1

 5 U.S.C. § 8101 et seq. 

2

 The Board notes that appellant submitted additional evidence after OWCP rendered its November 30, 2015 

decision. The Board’s jurisdiction is limited to reviewing the evidence that was before OWCP at the time of its final 

decision. Therefore, this additional evidence cannot be considered by the Board. 20 C.F.R. § 501.2(c)(1); Dennis E. 

Maddy, 47 ECAB 259 (1995); James C. Campbell, 5 ECAB 35, 36 n.2 (1952). 
2

On appeal, appellant asserts that he called in sick on October 18, 2015, tried to return to 

work on October 19, 2015, but had to leave immediately to go to the hospital. He submitted 

additional documents on appeal. 

FACTUAL HISTORY 

On October 19, 2015 appellant, then a 28-year-old correctional officer, filed a traumatic 

injury claim (Form CA-1) alleging that on October 17, 2015 he injured his left hand when 

placing handcuffs on an inmate. His supervisor noted on the claim form that his injury occurred 

in the performance of duty. 

In support of his claim appellant submitted discharge instructions from the Medical 

Center of Southeast Texas, which indicated that he was seen on October 19, 2015 by Dr. Jacob 

Vigil, a physician Board-certified in emergency medicine, and was diagnosed with nondisplaced 

fracture of proximal phalanx of left thumb. He was prescribed Tramadol, provided with general 

discharge instructions for a fractured thumb, and referred to a surgeon for follow up. Lisa 

Holland, a nurse practitioner, signed a work release form verifying that appellant was treated in 

the emergency department and was able to return to work on October 20, 2015 with restrictions 

of no use of the left hand for 30 days or until evaluated by an orthopedist. 

In a November 19, 2015 work release form a physician with an unidentifiable signature, 

indicated that appellant kept his appointment on that date, and that he may not return to work for 

two weeks. 

By letter dated October 21, 2015, OWCP informed appellant that further evidence, 

including factual and medical evidence, was necessary to support his claim, and afforded him 

30 days to submit this evidence. It found that the evidence was insufficient to establish that the 

incident occurred as alleged, and that the medical evidence neither provided a diagnosis or 

rationale relating a condition or injury to the incident. A questionnaire was provided which 

asked appellant to describe where he was and what he was doing when the injury occurred. 

Appellant did not submit any evidence within the 30-day time period. 

By decision dated November 30, 2015, OWCP denied appellant’s claim because he had 

not submitted sufficient evidence to establish that the event occurred as described. 

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 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. 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.3 

 3 Jussara L. Arcanjo, 55 ECAB 281, 283 (2004). 
3

In order to determine whether an employee actually sustained an injury in the 

performance of duty, OWCP begins with an analysis of whether fact of injury has been 

established. Generally, fact of injury consists of two components, which must be considered in 

conjunction with one another. The first component to be established is that the employee 

actually experienced the employment incident or exposure which is alleged to have occurred.4

 In 

order to meet his or her burden of proof to establish the fact that he or she sustained an injury in 

the performance of duty, an employee must submit sufficient evidence to establish that he or she 

actually experienced the employment injury or exposure at the time, place, and in the manner 

alleged.5

The second component is whether the employment incident caused a traumatic injury and 

generally can be established only by medical evidence.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

An injury does not have to be confirmed by eyewitnesses in order to establish the fact 

that an employee sustained an injury in the performance of duty, but the employee’s statements 

must be consistent with the surrounding facts and circumstances and his or her subsequent course 

of action.8

 An employee has not met his or her burden of proof of 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.9 Such circumstances 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 sufficient doubt on an employee’s 

statements in determining whether a prima facie case has been established.10 However, an 

employee’s statement alleging 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.11

 4 See Federal (FECA) Procedure Manual, Part 2 -- Claims, Fact of Injury, Chapter 2.803(2)(a) (August 2012). 

5 Linda S. Jackson, 49 ECAB 486 (1998). 

6 John J. Carlone, 41 ECAB 354 (1989); Horace Langhorne, 29 ECAB 820 (1978). 

7 Judith A. Peot, 46 ECAB 1036 (1995); Ruby I. Fish, 46 ECAB 276 (1994). 

8 M.H., 59 ECAB 461 (2008); George W. Glavis, 5 ECAB 363, 365 (1953). 

9 S.P., 59 ECAB 184 (2007). 

10 Barbara R. Middleton, 56 ECAB 634 (2005). 

11 O.T., Docket No. 14-1803 (issued December 29, 2014); see also Wanda F. Davenport, 32 ECAB 552, 

556 (1981). 
4

ANALYSIS 

OWCP denied appellant’s claim because he failed to establish that the employment 

incident occurred as alleged. However, the Board finds that he has met his burden of proof to 

establish that the incident occurred. Appellant stated that on October 17, 2015 he injured his left 

hand while forcibly placing handcuffs on an inmate. He has consistently described the 

employment activity that caused the alleged injury. Appellant’s statement is consistent with his 

behavior. The record contains hospital records indicating that appellant was evaluated on 

October 19, 2015 and received treatment for an injury to his left thumb. Appellant also filed his 

claim on October 19, 2015. His supervisor noted on the claim form that the incident occurred in 

the performance of duty. The Board finds that appellant’s statements are consistent with the 

surrounding facts and circumstances, including the fact that he sought medical treatment and 

filed a claim form within two days of the alleged incident. Accordingly, appellant has 

established that he experienced the employment incident on October 17, 2015.12 

The Board finds, however, that the medical evidence of record is insufficient to establish 

that appellant sustained a medical diagnosis causally related to the accepted employment 

incident. Appellant submitted notes indicating that he received treatment on October 19, 2015 at 

the Medical Center of Southeast Texas. However, the medical records with regard to this 

hospital visit do not include any description of the employment incident or provide any opinion 

indicating whether any injury was sustained as a result of the accepted employment incident. 

The Board also notes that the hospital records from appellant’s October 19, 2015 visit do not 

contain a physician’s signature. Although the records indicate that care was provided by 

Dr. Vigil and Ms. Holland, a nurse practitioner, the only signature is that of Nurse Holland. 

Medical evidence from a physician assistant or nurse practitioner does not constitute competent 

medical evidence under FECA.13 The work release form of November 19, 2015 also lacks a 

proper signature and does not address the circumstances of the employment incident. As noted, 

reports lacking medical identification do not constitute probative medical evidence.14 

An award of compensation may not be based on surmise, conjecture, or speculation.15 As 

appellant did not establish that his medical condition was causally related to the accepted 

employment incident, he has failed to meet 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. 

 12 See G.W., Docket No. 13-1943 (issued July 29, 2014). 

13 5 U.S.C. § 8102(2). See also V.C., Docket No. 16-0642 (issued April 19, 2016). 

14 V.R., Docket No. 14-1695 (issued January 9, 2015). 

15 D.I., 59 ECAB 158 (2007); Ruth R. Price, 16 ECAB 688, 691 (1965). 
5

CONCLUSION 

The Board finds that appellant has established that the October 17, 2015 occurred as 

alleged, but that he did not meet his burden of proof to establish that he sustained an 

employment-related injury causally related to the October 17, 2015 employment incident. 

ORDER 

IT IS HEREBY ORDERED THAT the decision of the Office of Workers’ 

Compensation Programs dated November 30, 2015 is affirmed as modified. 

Issued: July 15, 2016 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board