United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

K.G., Appellant 

and 

DEPARTMENT OF THE NAVY, 

PORTSMOUTH NAVAL SHIPYARD, 

Kittery, ME, Employer 

__________________________________________ 

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Docket No. 17-0943 

Issued: July 21, 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 

COLLEEN DUFFY KIKO, Judge 

JURISDICTION 

On March 30, 2017 appellant filed a timely appeal from a December 23, 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 a traumatic injury 

to the left fifth finger causally related to an accepted July 23, 2016 employment incident. 

FACTUAL HISTORY 

On August 2, 2016 appellant, then a 49-year-old firefighter, filed a traumatic injury claim 

(Form CA-1) alleging that, while turning the steering wheel of a fire engine at 10:30 a.m. on 

 1

 5 U.S.C. § 8101 et seq. 
2

July 23, 2016, he caught his left fifth finger on a pillar-mounted handle, bending the digit in an 

unnatural position as he turned the wheel, causing a sprain and dislocation. 

Appellant provided July 31, 2016 records from a hospital emergency room walk-in 

center. A physician assistant noted that appellant injured his left fifth finger “about nine days 

ago,” sustaining “a crush injury” at work. Appellant provided intake forms reiterating that the 

injury occurred at work on July 23, 2016, when his “left pinky got caught on a handle, mounted 

on a pillar” as he turned the steering wheel. The physician assistant diagnosed a sprain of the 

proximal interphalangeal joint of the left fifth finger. X-rays of the left fifth finger reviewed by 

Dr. Richard N. Gray, a Board-certified radiologist, showed normal alignment without fracture 

and unremarkable soft tissues. The physician assistant opined that the x-rays showed soft tissue 

swelling in the middle phalanx of the left fifth finger. She “buddy taped” appellant’s left fourth 

and fifth fingers and noted work restrictions. 

In an August 11, 2016 letter, OWCP notified appellant of the additional evidence needed 

to establish his claim, including a physician’s report explaining how the July 23, 2016 incident 

could have caused the claimed injury. It cautioned that the July 31, 2016 reports were not 

considered medical evidence as physician assistants were not considered physicians under 

FECA. OWCP afforded appellant 30 days to submit additional evidence. No additional 

evidence was received. 

By decision dated September 16, 2016, OWCP accepted that the July 23, 2016 

employment incident occurred at the time, place, and in the manner alleged, but denied the claim 

because there was no medical evidence of record signed by a physician diagnosing an injury 

causally related to the accepted July 23, 2016 incident. 

On October 4, 2016 appellant requested reconsideration. He submitted copies of the 

July 31, 2016 emergency room reports previously of record. 

By decision dated September 4, 2016, OWCP denied reconsideration, finding that the 

copies of previously submitted evidence were repetitive and, therefore, insufficient to warrant a 

review of the merits of the claim. 

On November 21, 2016 appellant again requested reconsideration. He contended that on 

July 23, 2016, his left fifth finger became “jammed against a handle mounted” on a pillar. 

Appellant alleged that a captain in the adjacent seat witnessed the incident and heard the “thud,” 

and that two other employees sustained similar injuries on the same handle, which was later 

removed from the pillar. He asserted that he delayed seeking treatment until July 31, 2016 as he 

had prior scheduled vacation plans beginning July 24, 2016. 

Appellant submitted a copy of the July 31, 2016 emergency room reports, signed on 

November 16, 2016 by Dr. Robert Hulefeld, Board-certified in emergency medicine and director 

of the walk-in unit where appellant was treated. Dr. Hulefeld noted his agreement with the 

assessment, diagnosis, and management provided by the physician assistant. 

By decision dated December 23, 2016, OWCP denied the claim finding that the medical 

evidence of record was insufficient to establish causal relationship. It noted that the physician 

assistant’s July 31, 2016 reports, as affirmed by Dr. Hulefeld, described a crush injury, differing 
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significantly from appellant’s account of the finger being bent in an unnatural position. OWCP 

therefore, found that Dr. Hulefeld’s opinion was not based on a complete and accurate history of 

the accepted incident, and was thus of insufficient probative value to establish a causal 

relationship between that incident and the claimed injury. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA2

 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 specific condition and/or disability for which compensation is claimed are 

causally related to the employment injury.3 

To determine whether an employee sustained a traumatic 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 that must be considered conjunctively. First, the 

employee must submit sufficient evidence to establish that he actually experienced the 

employment incident that is alleged to have occurred.4

 Second, the employee must submit 

sufficient evidence, generally only in the form of medical evidence, to establish that the 

employment incident caused a personal injury.5 

The medical evidence required to establish causal relationship is generally rationalized 

medical opinion evidence. Rationalized medical opinion evidence is medical evidence which 

includes a physician’s rationalized opinion on the issue of whether there is 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.6

ANALYSIS 

Appellant claimed that he injured his left fifth finger at work on July 23, 2016 while 

driving a fire engine. In his August 2, 2016 claim (Form CA-1), he described catching his left 

fifth finger on a pillar-mounted handle and bending it in an unnatural position. Appellant 

clarified on November 17, 2016 that he jammed his finger against the handle, causing it to 

hyperextend as he turned the steering wheel. OWCP accepted this version of events as factual. 

 2 Supra note 1. 

3 J.F., Docket No. 09-1061 (issued November 17, 2009). 

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

5 Deborah L. Beatty, 54 ECAB 340 (2003).

6 Solomon Polen, 51 ECAB 341 (2000). 
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In support of his claim, appellant provided reports from a hospital walk-in center dated 

July 31, 2016, prepared by a physician assistant and signed on November 16, 2016 by 

Dr. Hulefeld, Board-certified in emergency medicine and director of the walk-in unit. These 

reports described a “crush injury” to the left fifth finger, but diagnosed a sprain of the proximal 

interphalangeal joint of the left fifth finger. The inconsistent description of the incident, reduce 

the probative quality of Dr. Hulefeld’s opinion.7 Moreover, appellant did not allege a crush 

injury. 

Additionally, Dr. Hulefeld did not set forth his medical reasoning supporting how the 

accepted mechanism of catching and bending appellant’s fifth finger against the handle would 

have caused the diagnosed sprain. This lack of medical rationale supporting Dr. Hulefeld’s 

conclusions further reduces the probative value of his opinion.8

The Board notes that OWCP notified appellant by August 11, 2016 letter of the need to 

provide rationalized medical evidence from a physician supporting causal relationship. As 

appellant failed to submit such evidence, he failed to meet his burden of proof. 

Appellant may submit additional evidence or argument with a written request for 

reconsideration to OWCP within one year of the date 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 failed to meet his burden of proof to establish a 

traumatic injury to the left fifth finger causally related to an accepted July 23, 2016 employment 

incident. 

 7 See Beverly R. Jones, 55 ECAB 465 (2004). 

8 See Frank D. Haislah, 52 ECAB 457 (2001) (medical reports not containing rationale on causal relationship are 

entitled to little probative value); Jimmie H. Duckett, 52 ECAB 332 (2001). 
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ORDER 

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

Compensation Programs dated December 23, 2016 is affirmed. 

Issued: July 21, 2017 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board