United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

W.L., Appellant

and

DEPARTMENT OF THE INTERIOR, 

NATIONAL PARK SERVICE, 

King of Prussia, PA, Employer

__________________________________________

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Docket No. 19-1581

Issued: August 5, 2020

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

JANICE B. ASKIN, Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On July 19, 2019 appellant filed a timely appeal from a June 26, 2019 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 June 26, 2019 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.
2

ISSUE

The issue is whether appellant has met his burden of proof to establish a medical condition 

causally related to the accepted May 13, 2019 employment incident.

FACTUAL HISTORY

On May 13, 2019 appellant, then a 52-year-old park ranger, filed a traumatic injury claim 

(Form CA-1) alleging that on that date he injured his lower back and right knee as a result of his 

pant leg getting caught when he was taking a scooter off the platform of a pick-up truck, causing 

him to twist fiercely while in the performance of duty. He did not immediately feel pain, but noted 

that he began to feel pain in his right flank to back and right knee as he continued to work. 

Appellant stopped work on May 14, 2019.

In a May 17, 2019 development letter, OWCP informed appellant that the evidence 

submitted was insufficient to establish his claim. It advised him of the factual and medical 

evidence necessary to establish his claim and also provided a questionnaire for completion. OWCP 

afforded appellant 30 days to provide the necessary factual information and medical evidence.

OWCP subsequently received a May 25, 2019 duty status report (Form CA-17) from a 

physician with an illegible signature. The form noted a date of injury of May 13, 2019 and 

description of injury as “twisting injury low back and knee.” The provider noted a diagnosis of 

low back and right knee pain and recommended that he resume full-time modified duty. 

By decision dated June 26, 2019, OWCP accepted that the May 13, 2019 employment 

incident occurred as alleged, but denied appellant’s traumatic injury claim because the evidence 

of record did not include medical evidence containing a diagnosis in connection with the accepted 

employment incident. Accordingly, it found that the requirements had not been met to establish

an injury as defined by FECA. 

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 timely filed within the applicable 

time limitation of FECA,4that an injury was sustained in the performance of duty as alleged, and 

that any disability or medical condition for which compensation is claimed is causally related to 

 

3 Supra note 1.

4 S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59 ECAB 178 (2007); Joe D. Cameron, 41 ECAB 

153 (1989). 
3

the employment injury.5 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.6

In order to determine whether a federal employee has sustained a traumatic injury in the 

performance of duty, OWCP must first determine whether fact of injury has been established.7 

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, place, and in the manner alleged.8 Second, the employee must submit evidence, generally 

only in the form of probative medical evidence, to establish that the employment incident caused 

a personal injury.9

Rationalized medical opinion evidence is 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 incident.10 

Neither the mere fact that, a disease or condition manifests itself during a period of employment, 

nor the belief that the disease or condition was caused or aggravated by employment factors or 

incidents is sufficient to establish causal relationship.11

ANALYSIS

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

condition causally related to the accepted May 13, 2019 employment incident. 

The only medical evidence submitted was a May 25, 2019 CA-17 form from a physician 

with an illegible signature. The Board has held, however, that reports that are unsigned or that 

bear illegible signatures cannot be considered as probative medical evidence because they lack 

proper identification.12 This report, therefore, is of no probative value to establish appellant’s 

claim. 

 

5

J.M., Docket No. 17-0284 (issued February 7, 2018); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40 

ECAB 312 (1988).

6 K.M., Docket No. 15-1660 (issued September 16, 2016); L.M., Docket No. 13-1402 (issued February 7, 2014); 

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

7 D.B., Docket No. 18-1348 (issued January 4, 2019); S.P., 59 ECAB 184 (2007).

8 D.S., Docket No. 17-1422 (issued November 9, 2017); Bonnie A. Contreras, 57 ECAB 364 (2006).

9 B.M., Docket No. 17-0796 (issued July 5, 2018); David Apgar, 57 ECAB 137 (2005); John J. Carlone, 41 ECAB 

354 (1989).

10 S.S., Docket No. 18-1488 (issued March 11 2019).

11 J.L., Docket No. 18-1804 (issued April 12, 2019).

12 G.N., Docket No. 19-0184 (issued May 29, 2019); Thomas L. Agee, 56 ECAB 465 (2005); Richard F. Williams, 

55 ECAB 343 (2004).
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As there is no medical evidence of record that establishes a medical diagnosis in connection 

with the accepted employment incident, appellant has not met his burden of proof to establish that 

he sustained an injury causally related to the accepted May 13, 2019 employment incident.

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 medical 

condition causally related to the accepted May 13, 2019 employment incident. 

ORDER

IT IS HEREBY ORDERED THAT the June 26, 2019 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: August 5, 2020

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board