United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

B.M., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Sandy, UT, Employer 

__________________________________________ 

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Docket No. 17-0324 

Issued: March 24, 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 

COLLEEN DUFFY KIKO, Judge 

ALEC J. KOROMILAS, Alternate Judge 

JURISDICTION 

On November 29, 2016 appellant filed a timely appeal of an October 27, 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 to consider the merits of the case.2

ISSUE 

The issue is whether appellant has met her burden of proof to establish a traumatic injury 

on September 10, 2016 occurring in the performance of duty. 

 1

 5 U.S.C. § 8101 et seq.

2

 The Board notes that appellant submitted additional evidence with the filing of her appeal to the Board. 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). Appellant may 

submit this evidence to OWCP, together with a formal request for reconsideration, pursuant to 5 U.S.C. § 8128(a) 

and 20 C.F.R. § 10.606(b)(2). 
2

FACTUAL HISTORY 

On September 14, 2016 appellant, then a 55-year-old distribution associate, filed a 

traumatic injury claim (Form CA-1) alleging on Saturday, September 10, 2016, she injured her 

right foot while performing her work duties. She reported that while she was moving a pallet 

around with a floor jack, she felt her right foot pop and it began hurting. Appellant took a break 

and then finished her shift. Her right foot continued to hurt on Sunday and she sought medical 

attention on Monday. 

Appellant submitted a duty status report (Form CA-17) dated September 15, 2016 

completed by Dr. Justin Banks, a podiatrist. Dr. Banks diagnosed tendinitis. In a separate form, 

also dated September 15, 2016, he indicated that appellant sustained a right foot and ankle injury 

while moving equipment at work. Dr. Banks reported severe pain and right tibial tenderness 

with possible fracture. He indicated by checking a box marked “yes” on a form report that 

appellant’s condition was caused or aggravated by employment activities. 

OWCP requested additional information from appellant on September 22, 2016 and 

afforded her 30 days to respond. It asked that appellant complete a questionnaire and submit 

additional factual evidence. 

OWCP received an authorization for examination (Form CA-16) signed by the 

employing establishment which noted that she was moving mail with a floor jack and heard and 

felt her right foot pop. The physician’s section of the form was a duplicate of the September 15, 

2016 form report by Dr. Banks. Appellant provided an October 1, 2016 Form CA-17 from 

Dr. Banks indicating injury to a medial ankle ligament and diagnosing tendinitis and ankle 

sprain. 

In an undated narrative report, Dr. Banks noted that he first treated appellant on 

September 12, 2016 due to her ankle injury. He noted that on September 10, 2016 appellant was 

moving a pallet with a jack and heard a pop in her lower leg. Appellant had pain and sought 

treatment. Dr. Banks found severe tenderness along the post-tibial tendon and medial ankle. He 

reported that x-rays were negative for a fracture, but that appellant’s lower ankle and foot were 

very swollen with ecchymosis. Dr. Banks diagnosed a suspected posterior tibial tendon partial 

tear or severe sprain. He found that appellant was temporarily totally disabled due to the 

inability to bear weight on her foot. 

Appellant responded to OWCP’s request for factual information and in her questionnaire 

responses noted that her injury occurred on Saturday, September 10, 2016, while she was 

moving a pallet to the carrier cases with a floor jack. She had received permission to sign-in 

early and leave early. Appellant placed the pallet on the floor jack, and began walking when she 

heard her foot pop under her heel. She took her last break before leaving work. Appellant 

experienced foot pain beginning Saturday night, and she elevated and iced it. Her foot was 

swollen on Sunday morning. Appellant used leave on Monday, September 12, 2016, and 

contacted her physician. She worked on September 13, 2016 while wearing a prescribed boot 

and reported her injury on September 14, 2016. 

The employing establishment offered appellant a limited-duty position on October 4, 

2016 which entailed sitting only with no standing. 
3

By decision dated October 27, 2016, OWCP denied appellant’s traumatic injury claim as 

she failed to provide sufficient factual evidence to establish that the employment incident 

occurred as alleged. It also noted that appellant failed to provide sufficient medical evidence to 

establish causal relationship. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA3 has the burden of proof to establish the 

essential elements of his or her claim by the weight of the reliable, probative, and substantial 

evidence, 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 

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

injury.4

 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.5

OWCP defines a traumatic injury as, “[A] condition of the body caused by a specific 

event or incident, or series of events or incidents, within a single workday or shift. Such 

condition must be caused by external force, including stress or strain which is identifiable as to 

time and place of occurrence and member or function of the body affected.”6 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 

which is alleged to have occurred.7 The second component is whether the employment incident 

caused a personal injury and generally can be established only by medical evidence. 

With respect to the first component of fact of injury, the employee has the burden of 

establishing the occurrence of an injury at the time, place, and in the manner alleged, by a 

preponderance of the reliable, probative, and substantial evidence. 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 her subsequent course of action. An employee has not met 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. 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. However, an employee’s statement alleging that an injury 

 3

 5 U.S.C. §§ 8101-8193. 

4 Kathryn Haggerty, 45 ECAB 383, 388 (1994); Elaine Pendleton, 41 ECAB 1143 (1989). 

5 Victor J. Woodhams, 41 ECAB 345 (1989). 

6

 20 C.F.R. § 10.5(ee). 

7 Elaine Pendleton, supra note 4. 
4

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.8

 

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.9 A 

medical report is of limited probative value on a given medical question if it is unsupported by 

medical rationale.10 Medical rationale includes a physician’s detailed opinion on the issue of 

whether these is a causal relationship between the claimant’s diagnosed condition and the 

implicated employment activity. The opinion of the physician must be based on a complete 

factual and medical background of the claim, 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 specific employment activity or factors identified by the claimant.11

ANALYSIS 

The Board finds that appellant failed to meet her burden of proof to establish a traumatic 

injury on September 10, 2016 occurring in the performance of duty. 

With regard to the first element of a fact of injury, appellant alleged that she sustained a 

right foot injury on September 10, 2016. She consistently reported on statements to OWCP and 

the employing establishment as well as to her physician that while she was moving a pallet 

around with a floor jack, she felt her right foot pop. Following this incident on Saturday, 

September 10, 2016, appellant experienced foot pain and sought medical treatment on 

September 12, 2016. The Board finds that appellant’s statements are consistent with the 

surrounding facts and circumstances and her subsequent course of action. She notified the 

employing establishment of her injury on September 14, 2016, within four days of her injury, 

obtained medical treatment on September 12, 2016 within two days of the alleged injury, one of 

which was a Sunday, and attempted to return to work on September 13, 2016. The Board finds 

that the September 10, 2016 incident, moving a pallet with a floor jack, occurred as alleged. 

While appellant has established that the September 10, 2016 incident occurred, she has 

not established a causal relationship between her work incident and the diagnosed conditions of 

tendinitis and ankle sprain. A Form CA-16 authorization for medical treatment was issued by 

the employing establishment on September 14, 2016.12 Appellant submitted medical evidence 

from Dr. Banks who described appellant’s history of injury as while moving a pallet with a jack 

 8 D.B., 58 ECAB 464, 466-67 (2007). 

9 J.Z., 58 ECAB 529 (2007). 

10 T.F., 58 ECAB 128 (2006). 

11 A.D., 58 ECAB 149 (2006). 

12 When the 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 Form CA-16 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. 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); Tracy P. Spillane, 54 ECAB 

608, 610 (2003). 
5

and hearing a pop sound in her right lower extremity. Dr. Banks provided findings including 

swelling and x-rays which did not indicate a fracture. He noted, “I suspected a posterior tibial 

tendon partial tear or severe sprain.” Dr. Banks also diagnosed tendinitis and ankle sprain on his 

Form CA-17s. He indicated with a checkmark “yes” on a form report that appellant’s condition 

was caused by her employment activity, but offered no explanation or reasoning in support of 

this opinion. The Board has held that an opinion on causal relationship which consists only of a 

physician checking “yes” to a medical form report question on whether the claimant’s condition 

was related to the history given is of little probative value. Without any explanation or rationale 

for the conclusion reached, such report is insufficient to establish causal relationship.13 A mere 

conclusory opinion provided by a physician without the necessary rationale explaining how and 

why the incident or work factors were sufficient to result in the diagnosed medical condition is 

insufficient to meet a claimant’s burden of proof to establish a claim.14 Dr. Banks has not offered 

sufficient explanation to address how moving pallets with a floor jack on September 10, 2016 

caused or aggravated a diagnosed medical condition. 

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 failed to meet her burden of proof to establish a traumatic 

injury on September 10, 2016 occurring in the performance of duty. 

 13 Lucrecia M. Nielson, 41 ECAB 583, 594 (1991). 

14 J.D., Docket No. 14-2061 (issued February 27, 2015). 
6

ORDER 

IT IS HEREBY ORDERED THAT the October 27, 2016 decision of the Office of 

Workers’ Compensation Programs is affirmed, as modified. 

Issued: March 24, 2017 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board