United States Department of Labor

Employees’ Compensation Appeals Board

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R.F., Appellant

and

DEPARTMENT OF HOMELAND SECURITY, 

IMMIGRATION & CUSTOMS 

ENFORCEMENT, Plantation, FL, Employer

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Docket No. 18-1218

Issued: February 7, 2019

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

ALEC J. KOROMILAS, Alternate Judge

JURISDICTION

On May 29, 2018 appellant filed a timely appeal from an April 19, 2018 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

 

1 5 U.S.C. § 8101 et seq.

2 The Board notes that following the April 19, 2018 decision, OWCP received additional evidence. However, the 

Board’s Rules of Procedure provides: “The Board’s review of a case is limited to the evidence in the case record that 

was before OWCP at the time of its final decision. Evidence not before OWCP will not be considered by the Board 

for the first time on appeal.” 20 C.F.R. § 501.2(c)(1). Thus, the Board is precluded from reviewing this additional 

evidence for the first time on appeal. Id.
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ISSUE

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

in the performance of duty on September 19, 2017, as alleged. 

FACTUAL HISTORY

On October 5, 2017 appellant, then a 54-year-old deportation officer, filed a traumatic 

injury claim (Form CA-1) alleging that, at 10:30 a.m. on September 19, 2017, he was at the 

employing establishment’s target range performing required firearms training in full body armor 

when he began perspiring profusely, became lethargic, lost span of time momentarily, and became 

slightly incoherent. He stopped work on September 19, 2017 and returned to work on 

October 10, 2017.

Appellant sought medical treatment at an emergency room on the date of injury. In a 

September 19, 2017 report, Dr. Jennifer A. Fernandez, an emergency medicine physician, 

provided a final diagnosis of near syncope. Diagnostic tests results were also provided.

Work excuse notes dated September 27 and October 3, 2017, from a physician with an 

illegible signature, indicated that appellant had a work-related near syncope episode.

In a February 9, 2018 report, Dr. Victor H. Faradji, a neurologist, noted that appellant had 

recurrent episodes of lightheadedness since September 2017. He reported that the first episode 

occurred while appellant was at a shooting range, a second similar incident occurred at a shooting 

range in December 2017, and a third episode occurred at home, where appellant apparently hit his 

head. Dr. Faradji reported that appellant had not worked “since December 2017.” He provided 

an assessment of near syncope and noted that episodes could be in part related to hypokalemia or 

dehydration. Dr. Faradji noted that a February 12, 2018 awake electroencephalography (EEG) test 

was within normal limits. He also noted results of a February 21, 2018 carotid ultrasound.

By development letter dated March 12, 2018, OWCP notified appellant that his claim was 

initially administratively handled to allow medical payments, as it appeared to involve a minor 

injury resulting in minimal or no lost time from work. However, appellant’s claim was reopened 

for consideration of the merits because his medical bills had exceeded $1,500.00. OWCP informed 

him that the evidence of record was insufficient to establish his traumatic injury claim. It noted 

that the evidence was insufficient to establish that appellant actually experienced the incident or 

employment factor alleged to have caused injury; no diagnosis of any condition resulting from his 

injury had been provided; the evidence was insufficient to support that he was injured while 

performing any duty of his employment; and a physician’s opinion as to how his injury resulted in 

the condition diagnosed had not been provided. OWCP advised him of the type of factual and 

medical evidence necessary to establish his claim and included a questionnaire for his completion. 

It afforded appellant 30 days to submit additional evidence.

In response, appellant submitted copies of medical reports previously of record. 

By decision dated April 19, 2018, OWCP denied appellant’s claim. It found that he had 

not established that a specific employment event(s) occurred as alleged, therefore he had not
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established the factual component of his claim. OWCP further noted that appellant had not 

submitted medical evidence that established a diagnosed medical condition causally related to an 

employment injury or event, therefore fact of injury had not been established. 

LEGAL PRECEDENT

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

essential elements of his 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 each and every compensation claim regardless of whether the 

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

To determine whether a federal employee 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 and

place, and in the manner alleged. Second, the employee must submit medical evidence to establish 

that the employment incident caused a personal injury.5

Appellant’s burden of proof includes the submission of a detailed description of the 

employment factors which he or she believes caused or adversely affected a condition for which 

compensation is claimed.6

ANALYSIS

The Board finds that appellant has not met his burden of proof to establish a traumatic 

injury in the performance of duty on September 19, 2017, as alleged. 

On his Form CA-1, appellant noted that on September 19, 2017 he was at the employing 

establishment’s target range, wearing body armor, when he began perspiring, became lethargic, 

and became incoherent. He did not identify specific employment factors alleged to have caused 

his condition. The Board notes that his limited description of the traumatic incident fails to provide 

sufficient details to determine the circumstances surrounding his injury.7 The alleged mechanism 

of injury could not be determined as essential information such as a description of the activities 

 

3 B.G., Docket No. 16-0121 (issued May 19, 2016); C.S., Docket No. 08-1585 (issued March 3, 2009); Bonnie A. 

Contreras, 57 ECAB 364 (2006).

4 B.G., id.; S.P., 59 ECAB 184 (2007); Joe D. Cameron, 41 ECAB 153 (1989).

5 B.G., id.; T.H., 59 ECAB 388 (2008).

6 See D.C., Docket No. 18-0082 (issued July 12, 2018); S.J., Docket No. 17-1798 (issued February 23, 2018).

7 K.S., Docket No. 17-2001 (issued March 9, 2018). 
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appellant performed on the target range was not provided.8 The only explanation provided 

pertaining to the claimed September 19, 2017 traumatic incident was the limited statement noted 

in his Form CA-1. By failing to sufficiently describe the employment incident and circumstances 

surrounding his alleged injury, appellant has not established that the traumatic injury occurred at 

the time, place, and in the manner alleged.9

In a March 12, 2018 development letter, OWCP informed appellant that the evidence of 

record was insufficient as he had not sufficiently described the employment factors alleged to have 

caused his injury. Appellant was asked to describe those alleged work factors in detail, but he did 

not respond to OWCP’s request for additional factual information.10 Accordingly, as he failed to 

present a clear factual statement identifying specific employment factors or conditions alleged to 

have caused or contributed to his claimed medical condition, he has not met his burden of proof.11

As appellant has not established the factual element of his claim, the Board will not address 

the medical evidence.

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 has not met his burden of proof to establish a traumatic 

injury in the performance of duty on September 19, 2017, as alleged. 

 

8 See R.V., Docket No. 17-1286 (issued December 5, 2017).

9 P.T., Docket No. 14-0598 (issued August 5, 2014).

10 K.S., supra note 7; see also K.W., Docket No. 16-1656 (issued December 15, 2016).

11 See D.C., supra note 6; D.D., 57 ECAB 734 (2006).
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ORDER

IT IS HEREBY ORDERED THAT the April 19, 2018 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: February 7, 2019

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate Judge

Employees’ Compensation Appeals Board