United States Department of Labor 

Employees’ Compensation Appeals Board 

_________________________________________ 

T.S., Appellant 

and 

DEPARTMENT OF THE NAVY, 

Camp Lejeune, NC, Employer 

_________________________________________ 

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Docket No. 16-0830 

Issued: October 14, 2016 

Appearances: Case Submitted on the Record 

Appellant, pro se

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

COLLEEN DUFFY KIKO, Judge 

ALEC J. KOROMILAS, Alternate Judge 

JURISDICTION 

On April 12, 2016 appellant filed a timely appeal from a February 5, 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 met his burden of proof to establish a traumatic injury in 

the performance of duty on July 17, 2015. 

 1

 5 U.S.C. § 8101 et seq.

2

 Appellant submitted additional evidence with his appeal to the Board. The Board cannot consider this evidence 

as its review is limited to evidence which was before OWCP at the time of its merit decision. 20 C.F.R. 

§ 501.2(c)(1); P.W., Docket No. 12-1262 (issued December 5, 2012). 
2

FACTUAL HISTORY 

On July 22, 2015 appellant, then a 64-year-old woodworker filed a traumatic injury claim 

(Form CA-1) alleging that on July 17, 2015 he sustained an injury to his lower back when he 

bent over, stood up and pinched his lower back in the performance of duty. The employing 

establishment indicated that appellant was not in the performance of duty at the time of the 

incident as he was cleaning a small grill that weighed less than four pounds. The supervisor, 

Donnie Player, checked the box marked “no” in response to whether the knowledge of the facts 

about the injury agreed with statements of the employee and or witnesses. He noted that 

appellant had told him on July 21, 2015 that he had a back injury, but he believed that the back 

pain could have been from kidney stones, which appellant had admitted earlier. Appellant did 

not stop work. 

By letter dated July 24, 2015, OWCP advised appellant that additional evidence was 

required to support his claim. Appellant was advised of the medical and factual evidence needed 

and was asked to respond to the questions provided in the letter within 30 days. 

OWCP received a copy of appellant’s light-duty assignment dated July 23, 2015, an 

imaging order, light-duty restrictions from Dr. Michael Mahan a Board-certified family 

practitioner, dating from July 20 to 22, 2015. 

In a July 22, 2015 report, Gary Billings, a coworker, advised that he was working with 

appellant on July 17, 2015 cleaning up after a cookout when appellant commented that he had a 

pain in his back and it felt like it was tightening up. He noted that appellant continued working 

for the rest of the day but noticed that he seemed to favor his back more than usual. Mr. Billings 

advised that he did not ask to see the doctor and he continued to work. 

Appellant stated on July 17, 2015 that he was bent over cleaning a grill from a cook out. 

He noted that he stood up and felt a pinch in his lower back. Appellant explained that he 

continued with what he was doing, ignoring the pain. He explained that when he got up the next 

day, he could not stand up straight and he was in a lot of pain. 

In a July 22, 2015 statement, Mr. Player noted that on July 21, 2015 appellant had called 

him and told him he had a back injury. He noted that appellant had been off on Monday due to 

kidney stones and he wondered if appellant was really in pain from the kidney stones. 

In a July 22, 2015 report, Dr. Earl Frantz, Board-certified in family medicine, noted that 

appellant was bending over to clean a grill and felt a pinching sensation in his lower back on 

July 17, 2015. Appellant reported pain radiating down both lower extremities, with the left 

greater than the right with a tingling sensation. Dr. Frantz reported that appellant had a longstanding history of back issues with radiculopathy, and he was currently having radiculitis and 

lower back issues and wanted to consider different invasive modalities. He diagnosed lumbar 

sprain and unspecified thoracic or lumbosacral neuritis or radiculitis. Dr. Frantz continued to 

treat appellant and provided several disability certificates. In a July 29, 2015 disability 

certificate, he recommended a return to full duty on August 2, 2015. 
3

Dr. Matthew J. Swiber, a Board-certified anesthesiologist, saw appellant on August 18, 

26 and 28, 2015 for treatment which included a spinal procedure and recommended a return to 

work on August 31, 2015. 

By decision dated September 2, 2015, OWCP denied appellant’s claim as the evidence of 

record was insufficient to establish that the events occurred as described. It noted that he did not 

respond to its questionnaire. 

On September 29, 2015 appellant requested reconsideration. He noted that he had 

misplaced his doctor’s notes and was submitting them. In a July 29, 2015 report, Dr. Frantz 

diagnosed low back pain, lumbar sprain, lumbar radiculopathy and thoracic or lumbosacral 

neuritis or radiculitis, unspecified. OWCP received copies of previously submitted reports. 

By decision dated December 21, 2015, OWCP affirmed as modified the September 2, 

2015 decision. It found that the witness statements and appellant’s statements confirmed that the 

incident had occurred as alleged. However, the claim remained denied as there was insufficient 

evidence to establish the incident was in the performance of duty. 

On January 8 and 12, 2016 appellant requested reconsideration. He argued that the cook 

out was held during his normal designated lunch period and the grill was used to cook items 

which were to be consumed at that time at his place of employment. Appellant provided 

statements from his Mr. Billings and his supervisor, Mr. Player. They agreed that the incident 

happened at the place of employment as stated. 

On February 2, 2016 a telephone conference was held by OWCP with the employing 

establishment. It was confirmed that on July 17, 2015 appellant was cleaning a very small grill 

weighing less than four pounds and that he simply stood up and injured his back. The employing 

establishment confirmed that the incident occurred during an approved lunch break on the 

employment premises. It asserted that the matter should not be considered a recreational injury, 

but rather a single event on the premises of the employing establishment. 

By decision dated February 5, 2016, OWCP affirmed as modified the prior decision. It 

denied the claim because the medical evidence of record failed to establish causal relationship 

between the work incident and a diagnosed medical condition. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA has the burden of establishing 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 FECA3 and that an injury was sustained in the performance of duty.4 These 

 3 Joe D. Cameron, 41 ECAB 153 (1989). 

4 James E. Chadden, Sr., 40 ECAB 312 (1988). 
4

are the essential elements of each compensation claim, regardless of whether the claim is 

predicated upon a traumatic injury or an occupational disease.5

To determine whether a federal employee has sustained a traumatic injury in the 

performance of duty, it first must be determined whether the fact of injury has been established. 

There are two components involved in establishing the fact of injury. First, the employee must 

submit sufficient evidence to establish that he actually experienced the employment incident at 

the time, place, and in the manner alleged.6 In some traumatic injury cases, this component can 

be established by an employee’s uncontroverted statement on the Form CA-1.7 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.8 

Rationalized medical opinion evidence is generally required to establish causal 

relationship. The opinion of the physician must be based on a complete factual and medical 

background, 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.9

ANALYSIS 

In this case, appellant alleged that on July 17, 2015 he sustained an injury to his lower 

back when he bent over to clean a small grill, stood up, and pinched his lower back during lunch 

on the employing establishment’s premises. OWCP accepted that the claimed event occurred in 

the performance of duty. 

However, OWCP found the medical evidence was insufficiently rationalized to establish 

that the accepted employment incident caused an injury. The medical evidence of record 

contains no reasoned explanation of how the specific employment incident on July 17, 2015 

caused or aggravated an injury.10 

Dr. Frantz provided a July 22, 2015 report but did not provide a specific and reasoned 

opinion regarding whether the accepted incident caused or aggravated a diagnosed medical 

condition.11 

 5 Delores C. Ellyett, 41 ECAB 992 (1990). 

6 Julie B. Hawkins, 38 ECAB 393, 396 (1987). 

7 John J. Carlone, 41 ECAB 354 (1989). 

8 Id. For a definition of the term “traumatic injury,” see 20 C.F.R. § 10.5(ee). 

9 I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 ECAB 345 (1989). 

10 See George Randolph Taylor, 6 ECAB 986, 988 (1954) (where the Board found that a medical opinion not 

fortified by medical rationale is of little probative value). 

11 See id.; Charles H. Tomaszewski, 39 ECAB 461, 467-68 (1988) (finding that medical evidence which does not 

offer any opinion regarding the cause of an employee’s condition is of limited probative value on the issue of causal 

relationship). 
5

Other reports in the record such as the disability certificates from various physicians did 

not offer any opinion as to how the July 17, 2015 activities at work caused or aggravated a right 

leg or back condition.12

Because the medical reports submitted by appellant do not address how the July 17, 2015 

activities at work caused or aggravated a right leg or back condition, these reports are of limited 

probative value and are insufficient to establish that the July 17, 2015 employment incident 

caused or aggravated a specific injury. 

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 that he 

sustained a traumatic injury in the performance of duty on July 17, 2015. 

ORDER 

IT IS HEREBY ORDERED THAT the February 5, 2016 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: October 14, 2016 

Washington, DC 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board 

 12 Id.