United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

B.J., Appellant 

and 

DEPARTMENT OF THE ARMY, EVANS 

ARMY COMMUNITY HOSPITAL, 

Fort Carson, CO, Employer 

__________________________________________ 

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Docket No. 16-1660 

Issued: January 27, 2017 

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 August 16, 2016 appellant filed a timely appeal from a March 11, 2016 merit decision 

and an August 11, 2016 nonmerit 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. 

ISSUES 

The issues are: (1) whether appellant met his burden of proof to establish an injury 

causally related to an October 15, 2015 employment incident; and (2) whether OWCP properly 

denied appellant’s request for reconsideration pursuant to 5 U.S.C. § 8128(a). 

On appeal appellant asserts that his left elbow strain was caused by pulling a patient tray 

cart behind him for many months. 

 1

 5 U.S.C. § 8101 et seq. 
2

FACTUAL HISTORY 

On November 13, 2015 appellant, then a 38-year-old cook, filed a traumatic injury claim 

(Form CA-1) alleging that he injured his left elbow on October 15, 2015 in the performance of 

duty. He filed a second Form CA-1 for the same injury on December 16, 2015. Appellant 

alleged that he was pulling a cart when his elbow began to hurt. He did not stop work. 

Dr. Randall Jones, a family physician, provided an “initial visit” report on 

November 13, 2015. He described appellant’s report that he had a one-month history of left 

elbow pain that occurred when he pulled a very heavy food cart. Physical examination of the left 

elbow demonstrated mild tenderness over the lateral epicondyle and minimal tenderness over the 

medial epicondyle with full elbow range of motion and normal elbow strength. Resisted elbow 

extension test elicited pain. Tinel’s signs were negative at the ulnar nerve and the cubital tunnel. 

Dr. Jones reviewed a left wrist x-ray that demonstrated no acute bony abnormality and an area of 

distal humeral diaphysis that could be the result of old fracture or sessile osteochondroma.2

 He 

diagnosed left lateral and medial epicondylitis and advised that appellant could return to full duty 

without restrictions. 

Dr. Christopher Rodriguez, an osteopath at the employing establishment, noted on 

November 13, 2015 that appellant could return to duty without restrictions with an elbow 

brace/wrap while on duty. Appellant began physical therapy on November 23, 2015. 

On December 1, 2015 Dr. Jones noted appellant’s report that he was working full duty 

and that his elbow was not much better. He provided physical examination findings, again 

noting the painful resisted wrist extension. Dr. Jones diagnosed lateral epicondylitis and advised 

that appellant could return to full duty without restrictions. 

Dr. Wendy E. Miklos, Board-certified in preventive medicine and an employing 

establishment physician, advised on December 4, 2015 that appellant could return to full duty 

without restrictions with an elbow brace/wrap while on duty. 

On January 14, 2015 OWCP authorized three outpatient visits, an elastic covering, and 45 

units of physical therapy. Dr. Jones reiterated his findings and conclusions on January 5, 2016. 

On a State of Colorado workers’ compensation form dated January 20, 2016, he noted 

appellant’s description of the injury. Dr. Jones diagnosed lateral and medial epicondylitis and 

checked a box marked “yes,” indicating that his findings were consistent with the history and/or 

work-related mechanism of the injury. He recommended physical therapy, medication, and a 

tennis elbow support. 

In correspondence dated February 4, 2016, OWCP noted that appellant’s claim was 

initially administratively approved for payment of a limited amount of medical expenses. It 

explained that the merits of his claim had not been adjudicated and advised him of the medical 

evidence needed to establish further benefit entitlement, including his description of the claimed 

October 15, 2015 injury, a physician’s report explaining how the claimed injury caused a 

 2

 A copy of the x-ray report, done on November 13, 2015, is found in the case record. 
3

diagnosed condition, and his completion of an attached questionnaire. Appellant was afforded 

30 days to submit the requested information. 

On February 11, 2016 Dr. Robert W. Weien, Board-certified in aerospace and 

occupational medicine and an employing establishment physician, advised that appellant could 

return to full duty without restrictions. 

By decision dated March 11, 2016, OWCP denied the claim. It found that the 

employment incident of appellant pulling a food cart on October 15, 2015 occurred as alleged, 

but that the medical evidence of record was insufficient to establish that a medical condition 

occurred as a result of the accepted incident. 

Appellant requested reconsideration on July 7, 2016. In support of his request, appellant 

submitted evidence previously of record including the November 13, 2015 x-ray report, 

Dr. Jones’ November 13, 2015 and January 5, 2016 treatment notes, and physical therapy notes. 

On a May 4, 2016 State of Colorado workers’ compensation form, Dr. Jones repeated the exact 

findings and conclusions made in his January 20, 2016 form report. 

In a nonmerit decision dated August 11, 2016, OWCP denied appellant’s request for 

reconsideration. It found that the evidence submitted was duplicative of evidence previously of 

record. 

LEGAL PRECEDENT -- ISSUE 1 

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. Regardless of whether the asserted claim involves a 

traumatic injury or occupational disease, an employee must satisfy this burden of proof.3

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 or she 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.4

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

causal relationship is rationalized medical evidence.5

 The opinion of the physician must be 

based on a complete factual and medical background of the claimant, must be one of reasonable 

 3 Gary J. Watling, 52 ECAB 278 (2001). 

4

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

5 Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000). 
4

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 employee.6 Neither the mere fact that a disease or condition manifests itself during a period 

of employment nor the belief that the disease or condition was caused or aggravated by 

employment factors or incidents is sufficient to establish causal relationship.7

ANALYSIS -- ISSUE 1 

There is no dispute that, while at work on October 15, 2015, appellant was pulling a cart 

filled with food trays. The Board, however, finds that the medical evidence of record is 

insufficient to establish that this accepted incident resulted in an employment injury. 

Medical evidence submitted to support a claim for compensation should reflect a correct 

history and the physician should offer a medically sound explanation of how the claimed work 

event caused or aggravated the claimed condition.8 No physician did so in this case. 

The November 13, 2015 left elbow x-ray did not provide a cause of any diagnosed 

condition and medical evidence that does not offer any opinion regarding the cause of an 

employee’s condition is of limited probative value on the issue of causal relationship.9 Likewise, 

employing establishment physicians Dr. Rodriguez, Dr. Miklos, and Dr. Weien did not describe 

a cause of any diagnosed medical condition. While Dr. Jones checked a form box marked “yes,” 

indicating that his “findings were consistent with history that and/or work-related mechanism of 

injury/illness,” the Board has long held that when a physician’s opinion on causal relationship 

consists only of checking a box marked “yes” to a form question, that opinion has little probative 

value without medical rationale, and is insufficient to establish a causal relationship.10 He 

provided no additional explanation in support of his noted agreement on causation, his report 

lacks sufficient probative value to establish appellant’s claim. 

It is appellant’s burden of proof to establish a diagnosed medical condition causally 

related to the October 15, 2015 work incident. The Board finds that he has submitted insufficient 

evidence to meet his burden of proof to establish his claim.11

 6 Leslie C. Moore, 52 ECAB 132 (2000); Gary L. Fowler, 45 ECAB 365 (1994). 

7 Dennis M. Mascarenas, 49 ECAB 215 (1997). 

8 D.D., Docket No. 13-1517 (issued April 14, 2014). 

9 Willie M. Miller, 53 ECAB 697 (2002). 

10 Supra note 3. 

11 Where, as in this case, an employing establishment properly executes a Form CA-16, which authorizes medical 

treatment as a result of an employee’s claim for an employment-related injury, the CA-16 form creates a contractual 

obligation, which does not involve the employee directly, to pay for the cost of the examination or treatment 

regardless of the action taken on the claim. See Tracy P. Spillane, 54 ECAB 608 (2003). The period for which 

treatment is authorized by a Form CA-16 is limited to 60 days from the date of issuance, unless terminated earlier by 

OWCP. See 20 C.F.R. § 10.300(c). OWCP should further develop this aspect of the case. 
5

As to appellant’s assertions on appeal that his left elbow injury occurred over months of 

pulling the food cart, he retains the right to file an occupational disease claim.12

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. 

LEGAL PRECEDENT -- ISSUE 2 

Section 8128(a) of FECA vests OWCP with discretionary authority to determine whether 

it will review an award for or against compensation, either under its own authority or on 

application by a claimant.13 Section 10.608(a) of OWCP’s regulations provides that a timely 

request for reconsideration may be granted if OWCP determines that the employee has presented 

evidence and/or argument that meet at least one of the standards enumerated in section 

10.606(b)(3).14 This section provides that the application for reconsideration must be submitted 

in writing and set forth arguments and contain evidence that either: (1) shows that OWCP 

erroneously applied or interpreted a specific point of law; (2) advances a relevant legal argument 

not previously considered by OWCP; or (3) constitutes relevant and pertinent new evidence not 

previously considered by OWCP.15 Section 10.608(b) provides that when a request for 

reconsideration is timely, but fails to meet at least one of these three requirements, OWCP will 

deny the application for reconsideration without reopening the case for a review on the merits.16

ANALYSIS -- ISSUE 2 

With his July 7, 2016 reconsideration request, appellant did not show that OWCP 

erroneously applied or interpreted a specific point of law or advance a relevant legal argument 

not previously considered by OWCP. Consequently, he was not entitled to a review of the merits 

of the claim based on the first and second above-noted requirements under section 10.606(b).17 

As to the third above-noted requirement under section 10.606(b)(3), while appellant 

submitted a form report from Dr. Jones dated May 4, 2016, this was an exact duplicate of a form 

completed by the physician on January 20, 2016. Evidence or argument that repeats or 

 12 Under FECA an occupational disease or illness is a condition produced by the work environment over a period 

longer than a single workday or shift. 20 C.F.R. § 10.5(q). A traumatic injury, as appellant claimed in the case at 

hand, is a condition of the body caused by a specific event or incident, or series of events or incidents, within a 

single workday or shift. 20 C.F.R. § 10.5(ee). 

13 5 U.S.C. § 8128(a). 

14 20 C.F.R. § 10.608(a). 

15 Id. at § 10 608(b)(3). 

16 Id. at § 10 608(b). 

17 Id. at § 10.606(b). 
6

duplicates evidence previously of record has no evidentiary value and does not constitute a basis 

for reopening a case.18 

As appellant failed to show that OWCP erred in applying a point of law, advance a 

relevant legal argument not previously considered, or submit relevant and pertinent new 

evidence not previously considered by OWCP, OWCP properly denied his reconsideration 

request. 

CONCLUSION 

The Board finds that appellant did not meet his burden of proof to establish an injury 

causally related to an October 15, 2015 employment incident, and that OWCP properly denied 

his request for reconsideration pursuant to 5 U.S.C. § 8128(a). 

ORDER 

IT IS HEREBY ORDERED THAT the August 11 and March 11, 2016 decisions of the 

Office of Workers’ Compensation Programs are affirmed. 

Issued: January 27, 2017 

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 

 18 J.P., 58 ECAB 289 (2007).