United States Department of Labor

Employees’ Compensation Appeals Board

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D.J., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Indianapolis, IN, Employer

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Docket No. 18-0620

Issued: October 10, 2018

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 January 23, 2018 appellant filed a timely appeal from a September 18, 2017 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 his burden of proof to establish a traumatic injury 

causally related to the accepted July 23, 2017 employment incident.

 

1 5 U.S.C. § 8101 et seq.

2 The Board notes that following the September 18, 2017 decision OWCP received additional evidence in this 

claim. However, the Board’s jurisdiction is limited to the evidence that was of record at the time OWCP issued its 

final decision. Thus, the Board is precluded from reviewing this additional evidence for the first time on appeal. See 

20 C.F.R. § 501.2(c)(1); M.B., Docket No. 09-0176 (issued September 23, 2009); Donald R. Gervasi, 57 ECAB 

281 (2005).
2

FACTUAL HISTORY

On July 23, 2017 appellant, then a 22-year-old city carrier, filed a traumatic injury claim 

(Form CA-1) alleging that, on that date, his postal vehicle tipped over during a single vehicle 

accident. He reported that his back, right ankle, and right wrist were sore as a result of this incident. 

Appellant provided a narrative statement explaining that his vehicle’s brakes locked up on a rainslicked road, causing his vehicle to run off a seven-to-eight inch drop off on the side of the road 

and tip over onto rocks. He landed on his right forearm. Appellant was wearing his lap and 

shoulder belts at the time of the accident.

The record contains the first page of an authorization for examination or treatment (Form 

CA-16) dated July 23, 2017. Appellant’s supervisor, J.J., utilized the Form CA-16 to authorize

medical care for appellant for a period of up to 60 days and noted that there was doubt whether 

appellant’s condition was caused by an injury sustained in the performance of duty or otherwise 

related to his employment.

In a July 27, 2017 development letter, OWCP requested additional factual and medical 

evidence in support of appellant’s traumatic injury claim. It noted that he had not submitted any 

medical evidence which provided a diagnosis of any condition resulting from the alleged 

employment incident. OWCP afforded appellant 30 days to submit the necessary evidence. No 

response was received.

By decision dated September 18, 2017, OWCP accepted that the July 23, 2017 

employment incident occurred as alleged, but denied appellant’s claim, finding that he had failed 

to provide any medical evidence diagnosing a medical condition as a result of his July 23, 2017 

employment incident.

LEGAL PRECEDENT

An employee seeking benefits under FECA3 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 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. 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.4

To determine whether a federal employee has 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 

 

3 Supra note 1.

4 A.D., Docket No. 17-1855 (issued February 26, 2018); Gary J. Watling, 52 ECAB 357 (2001).
3

time and place, and in the manner alleged.5 Second, the employee must submit medical evidence 

to establish that the employment incident caused a personal injury.6 An employee may establish 

that an injury occurred in the performance of duty as alleged, but fail to establish that the disability 

or specific condition for which compensation is being claimed is causally related to the injury.7

Causal relationship is a medical issue and the medical evidence generally required to 

establish causal relationship is rationalized medical opinion evidence.8 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

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

injury causally related to the accepted July 23, 2017 employment incident.

Appellant did not submit any medical evidence in support of his claim. OWCP informed 

him regarding the evidence necessary to establish his claim in a development letter dated July 27, 

2017, but he did not respond. There is no evidence of record that establishes a medical diagnosis 

in connection with the accepted employment incident. Consequently, appellant failed to establish 

an injury in the performance of duty on July 23, 2017.10

On appeal appellant notes that he is only seeking reimbursement for the bills that resulted 

from a doctor’s visit. On July 23, 2017 the employing establishment issued him a Form CA-16 

authorizing medical treatment. OWCP did not address whether appellant is entitled to 

reimbursement of medical expenses pursuant to the Form CA-16. 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.11

 

5 A.D., id.; Elaine Pendleton, 40 ECAB 1143 (1989).

6 A.D., supra note 4; T.H., 59 ECAB 388 (2008); John J. Carlone, 41 ECAB 354 (1989).

7 A.G., Docket No. 17-1093 (issued June 5, 2018); Shirley A. Temple, 48 ECAB 404, 407 (1997).

8

Id.; Robert G. Morris, 48 ECAB 238 (1996).

9 A.D., supra note 4; I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 ECAB 345 (1989).

10 A.G., supra note 7.

11 See 20 C.F.R. § 10.300(c); Tracy P. Spillane, 54 ECAB 608, 610 (2003).
4

CONCLUSION

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

injury causally related to the accepted July 23, 2017 employment incident. 

ORDER

IT IS HEREBY ORDERED THAT the September 18, 2017 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: October 10, 2018

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