United States Department of Labor

Employees’ Compensation Appeals Board

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J.W., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Cleveland Heights, OH, Employer

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Docket No. 19-0335

Issued: July 2, 2019

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

ALEC J. KOROMILAS, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On November 30, 2018 appellant filed a timely appeal from an October 29, 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 

ISSUE

The issue is whether appellant has met her burden of proof to establish an injury in the 

performance of duty on September 5, 2018, as alleged.

 

1 5 U.S.C. § 8101 et seq.

2 The Board notes that, following the October 29, 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.
2

FACTUAL HISTORY

On September 17, 2018 appellant, then a 49-year-old city letter carrier, filed a traumatic 

injury claim (Form CA-1) alleging that on September 5, 2018 she sustained a bruised right arm 

and shoulder, bruised right eye, and swollen left knee when she fainted due to heat. On the reverse 

side of the claim form, the employing establishment indicated that she stopped work on 

September 5, 2018 and returned to work on September 13, 2018. It contended that appellant was 

not injured in the performance of duty and noted that she fainted while “delivering to her 

businesses” and “[appellant] was kept in the hospital for heart-related issues.” 

In a work excuse note dated September 7, 2018, Dr. Scott L. Massien, Board-certified in 

internal medicine, indicated that he treated appellant on September 7, 2018 and that she was to 

return to work on September 11, 2018. 

In an x-ray scan report dated September 9, 2018, Dr. Jawad Nesheiwat, a Board-certified 

diagnostic radiologist, noted impressions of no acute osseous abnormality and mild progression of 

mild-to-moderate degenerative changes of the left knee. 

In a duty status report (Form CA-17) dated September 11, 2018, Dr. Scott L. Massien, 

Board-certified in internal medicine, diagnosed syncope. He noted that appellant fainted due to 

heat outside, and indicated that she could return to work with restrictions. 

In a letter dated September 14, 2018, the employing establishment controverted appellant’s 

claim noting that she was taken to the hospital after fainting on her route. However, it alleged that 

the physician admitted her into the hospital after finding an air pocket on her heart. The employing 

establishment indicated that the hospital discharged appellant with a heart monitor and treated her 

for an upper respiratory infection and other illnesses. It alleged that the paramedics on the scene 

of the incident stated that they thought she passed out from the heat, however, her medical 

documentation did not indicate that heat was the cause. 

In a development letter dated September 26, 2018, OWCP advised appellant that the 

evidence of record was insufficient to establish that she actually experienced the incident alleged 

to have caused the injury as a result of her work duties, and that she had not submitted a physician’s 

opinion as to how her injury resulted in a diagnosed medical condition. It requested that she submit 

additional factual and medical evidence and provided a questionnaire for her completion. OWCP 

afforded appellant 30 days to submit the necessary evidence. No response was received. 

By decision dated October 29, 2018, OWCP denied appellant’s claim, finding that she was 

not in the performance of duty at the time of the alleged September 5, 2018 employment incident. 

It noted that the evidence she submitted for review did not support that her diagnosed condition of 

syncope was caused or contributed to by her federal employment. OWCP specifically related that 

it could not determine if appellant’s reported fall was idiopathic or unexplained because she had

not responded to the requested questionnaire. 
3

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 period 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 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

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

performance of duty it must first be determined whether fact of injury has been established.7 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 sufficient evidence to establish that the employment incident caused a personal injury.9

FECA provides for the payment of compensation for “the disability or death of an 

employee resulting from personal injury sustained while in the performance of duty.”

10

 “The 

phrase” sustained while in the performance of duty” has been interpreted by the Board to be the 

equivalent of the commonly found prerequisite in workers’ compensation law of “arising out of 

and in the course of employment.”

11

 The phrase “in the course of employment” is recognized as 

relating to the work situation, and more particularly, relating to elements of time, place, and 

circumstance. To arise in the course of employment, an injury must occur at a time when the 

employee may reasonably be stated to be engaged in the master’s business, at a place where he or 

she may reasonably be expected to be in connection with the employment, and while the employee 

was reasonably fulfilling the duties of his or her employment or engaged in doing something 

incidental thereto.”

12

 

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).

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 C.B., Docket No. 18-0071 (issued May 13, 2019); L.M., Docket No. 13-1402 (issued February 7, 2014); 

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

7 D.B., Docket o. 18-1348 (issued January 4, 2019); T.H., 59 ECAB 388, 393-94 (2008).

8 D.S., Docket No. 17-1422 (issued November 9, 2017); Elaine Pendleton, 40 ECAB 1143 (1989).

9 B.M., Docket No. 17-0796 (issued July 5, 2018); John J. Carlone, 41 ECAB 354 (1989).

10 5 U.S.C. § 8102(a).

11 G.R., Docket No. 18-1490 (issued April 4, 2019); Charles Crawford, 40 ECAB 474, 476-77 (1989).

12 G.R., id.; Mary Keszler, 38 ECAB 735, 739 (1987).
4

It is a well-settled principle of workers’ compensation law, and the Board has so held, that 

an injury resulting from an idiopathic fall -- where a personal, nonoccupational pathology causes

an employee to collapse and to suffer injury upon striking the immediate supporting surface, and 

there is no intervention or contribution by any hazard or special condition of employment -- is not 

within coverage of FECA.13 Such an injury does not arise out of a risk connected with the 

employment and is, therefore, not compensable. The Board has made equally clear, the fact that 

the cause of a particular fall cannot be ascertained or that the reason it occurred cannot be 

explained, does not establish that it was due to an idiopathic condition.

This follows from the general rule that an injury occurring on the industrial premises during 

working hours is compensable unless the injury is established to be within an exception to such 

general rule.14 If the record does not establish that the particular fall was due to 

an idiopathic condition, it must be considered as merely an unexplained fall, one which is 

distinguishable from a fall in which it is definitely proved that a physical condition preexisted and 

caused the fall.15

ANALYSIS

The Board finds that appellant has not met her burden of proof to establish an injury in the 

performance of duty on September 5, 2018, as alleged.

Appellant has not provided sufficient detail to establish that a traumatic incident occurred 

in the performance of duty as alleged.16 On her Form CA-1 she explained that she sustained a 

bruised right arm and shoulder, bruised right eye, and swollen left knee when she fainted due to 

heat while delivering mail in the performance of duty. On the reverse side of the Form CA-1, and 

in a separate letter, the employing establishment controverted the claim indicating that “[appellant]

was kept in the hospital for heart-related issues,” and not as a result of the alleged fall. Therefore, 

OWCP could not determine, based upon evidence of record, whether appellant’s fall was 

idiopathic or otherwise remained unexplained.17

Appellant was provided an opportunity to submit evidence to establish how her alleged 

injury occurred on September 5, 2018. By development letter dated September 26, 2018, OWCP 

requested that she describe the factual circumstances of her injury and provided her with a factual 

development questionnaire for completion. Appellant did not respond to the questionnaire and 

failed to provide a narrative statement detailing the traumatic incident prior to the issuance of 

OWCP’s denial of her claim on October 29, 2018. The only explanation she provided pertaining 

to the alleged September 5, 2018 employment incident is a general and vague statement noted on 

 

13 H.B., Docket No. 18-0278 (issued June 20, 2018); see Carol A. Lyles, 57 ECAB 265 (2005).

14 H.B., id.; Dora J. Ward, 43 ECAB 767, 769 (1992); Fay Leiter, 35 ECAB 176, 182 (1983).

15 H.B., id.; John R. Black, 49 ECAB 624 (1998); Judy Bryant, 40 ECAB 207 (1988); Martha G. List, 26 ECAB 

200 (1974).

16 Dennis M. Mascarenas, 49 ECAB 215, 218 (1997).

17 Supra note 15.
5

her Form CA-1. While appellant indicated that she fainted due to heat, she did not provide details 

such as the alleged circumstances surrounding her alleged injury e.g., outdoor temperature on 

September 5, 2018 and how long she had been exposed to this or any other factors as a result of 

delivering mail in the alleged “heat.” By failing to describe the employment incident and 

circumstances surrounding her alleged injury, she has not established that the traumatic injury 

occurred in the performance of duty, as alleged.18 Thus, the Board finds that appellant has not met 

her burden of proof.19

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 her burden of proof to establish an injury in the 

performance of duty on September 5, 2018, as alleged.

 

18 Id.

19 The Board notes that appellant was transported to the hospital. OWCP, however, did not adjudicate the issue of 

her incurred medical expenses or whether emergency or unusual circumstances were present. Ordinarily, the 

employing establishment will authorize treatment of a job-related injury by providing the employee a properly 

executed authorization for examination and/or treatment (Form CA-16) within four hours. In this case, the record 

does not contain a Form CA-16 or any other authorization from OWCP for medical treatment. However, under section 

8103 of FECA, OWCP has broad discretionary authority to approve unauthorized medical care which it finds 

necessary and reasonable in cases of emergency or other unusual circumstances. 5 U.S.C. § 8103; 20 C.F.R. § 10.304. 

See L.B., Docket No. 10-0469 (issued June 2, 2010); see also Federal (FECA) Procedure Manual, Part 3 -- Medical, 

Authorizing Examination and Treatment, Chapter 3.300.3a.(3) (February 2012) 
6

ORDER

IT IS HEREBY ORDERED THAT the October 29, 2018 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: July 2, 2019

Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board