United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

W.L., Appellant

and

DEPARTMENT OF THE NAVY, MARINE 

CORPS INSTALLATION FACILITIES &

ENVIRONMENT DIVISION, Quantico, VA, 

Employer

__________________________________________

)

)

)

)

)

)

)

)

)

)

Docket No. 19-0774

Issued: November 26, 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

JANICE B. ASKIN, Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On February 25, 2019 appellant filed a timely appeal from a September 4, 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 appellant submitted additional evidence on appeal. 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 cardiac condition 

causally related to the accepted factors of his federal employment. 

FACTUAL HISTORY

On March 6 and 13, 2018 appellant, then a 58-year-old high voltage electrician, filed 

traumatic injury claims (Form CA-1) alleging that on March 4, 2018 he experienced chest pains 

and a heart attack at approximately 9:30 a.m. while in the performance of duty.3 He stopped work 

that day. Appellant was admitted to the hospital for a ST-elevation myocardial infarction (STEMI) 

with stent and catheterization to left anterior descending (LAD) coronary artery. 

On March 8, 2018 the employing establishment provided appellant with an authorization 

for examination and/or treatment (Form CA-16) for “heart attack.”

In a development letter dated March 13, 2018, OWCP requested that appellant provide 

additional factual and medical information to support his claim. A factual questionnaire was 

provided for his completion. OWCP afforded appellant 30 days in which to submit the necessary 

evidence. 

OWCP received multiple hospital records, including diagnostic testing, from March 4 

through 6, 2018. In a March 4, 2018 report, Dr. Khalid A. Abousy, a Board-certified cardiologist, 

diagnosed an acute myocardial infraction. In a March 7, 2018 attending physician’s report (Form 

CA-20), he indicated that appellant would be totally disabled for approximately one to two months 

as a result of stent placement.

OWCP received progress notes dated March 13 and April 11, 2018, and an April 12, 2018 

attending physician’s report (Form CA-20) from Dr. Abousy regarding appellant’s atherosclerotic 

coronary artery disease, post March 4, 2018 STEMI anterior with stent and catheterization to LAD

coronary artery. 

By decision dated April 17, 2018, OWCP denied appellant’s traumatic injury claim as he 

had not established fact of injury. It found that the evidence submitted was insufficient to establish 

that the event occurred as described because appellant had not submitted a response to its 

questionnaire. OWCP concluded, therefore, that the requirements had not been met to establish 

an injury as defined by FECA. 

On April 26, 2018 appellant requested a review of the written record before an OWCP 

hearing representative. In an undated statement, he indicated that he had no prior history of cardiac 

illness and that he was an essential and key employee during inclement weather and emergency 

situations. On the day of the incident, appellant indicated that he was working under cold and 

inclement weather, which included extremely high winds, to restore power to Quantico Marine 

 

3 The initial Form CA-1 signed by D.P., Maintenance Mechanic Supervisor, indicated that appellant’s heart attack 

did not occur while in the performance of duty. The subsequent Form CA-1 signed by N.F., Agency Reviewer, 

indicated that appellant was injured while in the performance of duty. 
3

Core Base. The Base was under Code Red weather alert conditions and this was his third straight 

day of working 16-hour shifts. Appellant advised that his job required him to lift heavy equipment 

or materials averaging 50 pounds and above. He noted that the stress of working 16 hours per day, 

inappropriate equipment and gear, and the weight of the equipment and materials caused the stress 

and physical strain on his body which he believed caused or contributed to his symptoms of chest 

discomfort and body weakness and led to his cardiac condition. Appellant also described his work 

activities the week leading up to his heart attack. 

Additional medical reports from Dr. Abousy were received. In an April 30, 2018 report,

Dr. Abousy diagnosed coronary artery disease involving native coronary artery without angina 

pectoris; presence of drug-coated stent in LAD coronary artery; essential hypertension; and 

STEMI involving LAD coronary artery. In an April 30, 2018 a work capacity evaluation (Form 

OWCP-5c), Dr. Abousy indicated that appellant was totally disabled from March 4 through 

May 15, 2018. He advised that he could return to work with no restrictions on May 15, 2018. In 

May 21, June 27 and August 8, 2018 work capacity evaluations (Form OWCP-5c), Dr. Abousy 

provided appellant’s work-related restrictions. It also received a copy of Dr. Abousy’s 

Certification of Health Care Provider for Employee’s Serious Health Condition (Family and 

Medical Leave Act), which noted appellant’s medical course following his myocardial infraction. 

An April 26, 2018 echocardiogram report was also received. 

In a July 26, 2018 statement, D.P, Maintenance Mechanic Supervisor, indicated that on 

March 4, 2018 appellant was asked to work overtime to repair some of the damaged electrical lines 

that were knocked down by a wind storm that had occurred earlier in the week. He advised that 

appellant had worked volunteer overtime prior to March 4, 2018 for 16 hours, but not on 

March 4, 2018. D.P. included a copy of appellant’s time cards, noting that, on March 4, 2018, 

appellant had only worked 2.75 hours before falling ill and being taken to the hospital. He

indicated all of the duties appellant mentioned were his normal every day duties as a high voltage 

electrician. D.P. disputed appellant’s claim that the weather on March 4, 2018 was cold and 

inclement with extremely high winds and attached a copy of a weather report for March 4, 2018. 

He also disputed appellant’s claim that he had not been issued appropriate clothing and gear. 

By decision dated September 4, 2018, an OWCP hearing representative converted 

appellant’s traumatic injury claim into an occupational disease claim and affirmed OWCP’s

April 17, 2018 decision. The hearing representative found that appellant had established that his 

position had “physical requirements” and that “he was working when emergency treatment was 

obtained and he was treated for a myocardial infarction.” The hearing representative also found 

that the medical evidence of record failed to establish that appellant’s myocardial infarction was 

caused by his employment duties. 

LEGAL PRECEDENT

An employee seeking benefits under FECA4 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 

 

4 Supra note 1.
4

time limitation period of FECA,5that 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 the employment injury.6 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.7

To establish that an injury was sustained in the performance of duty in an occupational 

disease claim, a claimant must submit the following: (1) a factual statement identifying 

employment factors alleged to have caused or contributed to the presence or occurrence of the 

disease or condition; (2) medical evidence establishing the presence or existence of the disease or 

condition for which compensation is claimed; and (3) medical evidence establishing that the 

diagnosed condition is causally related to the employment factors identified by the claimant.8

The medical evidence required to establish causal relationship is rationalized medical 

opinion evidence.9 Rationalized medical opinion evidence is medical evidence which includes a 

physician’s rationalized opinion on the issue of whether there is causal relationship between the 

claimant’s diagnosed condition and the implicated employment factors. The opinion of the 

physician must be based on a complete factual and medical background of the claimant, 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.10

ANALYSIS

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

condition causally related to the accepted factors of his federal employment.

In support of his claim, appellant submitted several reports from Dr. Abousy which noted 

the March 4, 2018 myocardial infraction and placement of a stent in the LAD coronary artery. 

Dr. Abousy also diagnosed coronary artery disease, essential hypertension, and orthostasis. He,

however, has not provided an opinion as to the cause of appellant’s cardiac conditions. The Board 

has held that medical evidence that does not offer an opinion regarding the cause of an employee’s 

 

5 S.C., Docket No. 18-1242 (issued March 13, 2019); S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59 

ECAB 178 (2007); Joe D. Cameron, 41 ECAB 153 (1989).

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

Sr., 40 ECAB 312 (1988).

7 S.C., id.; 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).

8 C.D., Docket No. 17-2011 (issued November 6, 2018); Jacquelyn L. Oliver, 48 ECAB 232, 235-36 (1996).

9 M.B., Docket No. 17-1999 (issued November 13, 2018).

10 M.L., Docket No. 18-1605 (issued February 26, 2019).
5

condition is of no probative value on the issue of causal relationship.11 Therefore, Dr. Abousy’s 

reports are insufficient to establish appellant’s claim.

OWCP also received multiple diagnostic reports taken during appellant’s hospital stay 

along with an April 26, 2018 echocardiogram report. However, the Board has held that diagnostic 

test reports lack probative value as they do not provide an opinion on causal relationship between 

his employment incident and a diagnosed condition.12

Appellant’s honest belief that the factors of his federal employment caused his medical 

condition, however sincerely held, does not constitute medical evidence sufficient to establish 

causal relationship. As the record lacks rationalized medical evidence establishing causal 

relationship between the accepted employment duties and appellant’s cardiac conditions, the 

Board finds that appellant has not met his burden of proof.13

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 10.607.14

CONCLUSION

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

condition causally related to the accepted factors of his federal employment.

 

11 M.D., Docket No. 19-0338 (issued July 9, 2019); S.F., Docket No. 18-1030 (issued April 5, 2019); L.B., Docket 

No. 18-0533 (issued August 27, 2018); D.K., Docket No. 17-1549 (issued July 6, 2018).

12 T.H., Docket No. 18-1736 (issued March 13, 2019).

13 See B.K., Docket No. 19-0829 (issued September 25, 2019). 

14 The Board notes that the employing establishment issued a Form CA-16. A completed Form CA-16 authorization 

may constitute a contract for payment of medical expenses to a medical facility or physician, when properly executed. 

The form 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. See 20 C.F.R. § 10.300(c); J.G., Docket No. 17-

1062 (issued February 13, 2018); Tracy P. Spillane, 54 ECAB 608 (2003).
6

ORDER

IT IS HEREBY ORDERED THAT the September 4, 2018 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: November 26, 2019

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board