United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

D.Y., Appellant 

and 

DEPARTMENT OF VETERANS AFFAIRS, 

VETERANS HEALTH ADMINISTRATION, 

Milwaukee, WI, Employer 

__________________________________________ 

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Docket No. 17-0098 

Issued: March 28, 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 October 21, 2016 appellant filed a timely appeal from an October 6, 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.2

ISSUE 

The issue is whether appellant has met her burden of proof to establish a right hand 

condition in the performance duty, as alleged. 

 1

 5 U.S.C. § 8101 et seq. 

2

 Appellant submitted new evidence on appeal. The Board’s jurisdiction is limited to the review of evidence 

which was before OWCP at the time it rendered its decision. Thus, the Board is precluded from reviewing this 

evidence for the first time on appeal. See 20 C.F.R. § 501.2(c)(1). 
2

FACTUAL HISTORY 

On July 25, 2016 appellant, then a 56-year-old housekeeping aid, filed an occupational 

disease claim (Form CA-2) alleging that she injured her right hand as a result of “repetitive use 

doing daily housekeeping duties.” She first became aware of her claimed condition and of its 

relationship to her federal employment on June 15, 2016. 

By letter dated August 15, 2016, OWCP requested that appellant submit additional 

factual and medical evidence in support of her claim. It noted that she had not submitted any 

evidence regarding the employment factors alleged to have caused her injuries. OWCP further 

noted that appellant had not submitted any medical evidence in support of her claim. It afforded 

her 30 days to submit additional evidence and to respond to its inquiries. Appellant did not 

submit any further evidence. 

By decision dated October 6, 2016, OWCP denied appellant’s claim for compensation. It 

noted that she failed to provide sufficient evidence to establish that the alleged events occurred 

as alleged and she had failed to submit medical evidence to establish an injury. OWCP found 

that appellant had not submitted any evidence to support her claim. 

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, that an injury was sustained while in the performance of duty as alleged, and that any 

disability or specific condition for which compensation is claimed is causally related to the 

employment injury.3 These are the essential elements of every compensation claim regardless of 

whether the claim is predicated on a traumatic injury or an occupational disease.4 

To establish that an injury was sustained in the performance of duty in an occupational 

disease claim, a claimant must submit the following: (1) medical evidence establishing the 

presence or existence of the disease or condition for which compensation is claimed; (2) a factual 

statement identifying employment factors alleged to have caused or contributed to the presence 

or occurrence of the disease or condition; and (3) medical evidence establishing that the 

employment factors identified by the claimant were the proximate cause of the condition for 

which compensation is claimed or, stated differently, medical evidence establishing that the 

diagnosed condition is causally related to the employment factors identified by the claimant.5

 3 Gary J. Watling, 52 ECAB 278, 279 (2001); Elaine Pendleton, 40 ECAB 1143, 1145 (1989). 

4 Michael E. Smith, 50 ECAB 313, 315 (1999). 

5 R.H., 59 ECAB 382 (2008); Ernest St. Pierre, 51 ECAB 623 (2000). 
3

ANALYSIS 

The Board finds that appellant has not submitted sufficient factual evidence to establish 

the essential elements of her claim. As previously noted, in an occupational disease claim 

appellant must submit a factual statement identifying the employment factors alleged to have 

caused or contributed to the presence of her claimed condition.6

 She has not submitted a 

statement identifying the particular housekeeping duties alleged to have caused or contributed to 

her claimed condition. Appellant’s description of “repetitive use doing daily housekeeping 

duties” contained on the Form CA-2 lacks sufficient specificity to identify particular 

employment factors. Her burden of proof includes the submission of a detailed description of the 

employment factors or conditions which she believes caused or adversely affected a condition 

for which compensation is claimed.7

In an occupational disease claim appellant is also required to submit medical evidence of 

a diagnosed condition, and medical evidence establishing causal relationship between the 

diagnosed condition and the alleged factors of employment.8 However, she has failed to submit 

any medical evidence to establish a right hand condition. As there is no medical evidence 

explaining how specific employment factors caused or aggravated a medical condition involving 

appellant’s right hand, she has not met her burden of proof to establish her 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 did not meet her burden of proof to establish that she 

sustained a right hand condition in the performance of duty, as alleged. 

 6 Id. 

7 T.C., Docket No. 16-1070 (issued January 24, 2017). 

8 J.K., Docket No. 16-1850 (issued January 9, 2017). 
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ORDER 

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

Compensation Programs dated October 6, 2016 is affirmed. 

Issued: March 28, 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