United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

J.W., Appellant

and

U.S. POSTAL SERVICE, KANSAS CITY 

MARTIN POST OFFICE, Kansas City, MO, 

Employer

__________________________________________

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Docket No. 20-0598

Issued: December 2, 2020

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

CHRISTOPHER J. GODFREY, Deputy Chief Judge

JANICE B. ASKIN, Judge

PATRICIA H. FITZGERALD, Alternate Judge

JURISDICTION

On January 23, 2020 appellant, through counsel, filed a timely appeal from a September 13, 

2019 merit decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to the 

Federal Employees’ Compensation Act2(FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board 

has jurisdiction over the merits of this case.

 

1

In all cases in which a representative has been authorized in a matter before the Board, no claim for a fee for legal 

or other service performed on appeal before the Board is valid unless approved by the Board. 20 C.F.R. § 501.9(e). 

No contract for a stipulated fee or on a contingent fee basis will be approved by the Board. Id. An attorney or 

representative’s collection of a fee without the Board’s approval may constitute a misdemeanor, subject to fine or 

imprisonment for up to one year or both. Id.; see also 18 U.S.C. § 292. Demands for payment of fees to a 

representative, prior to approval by the Board, may be reported to appropriate authorities for investigation.

2 5 U.S.C. § 8101 et seq.
2

ISSUE

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

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

FACTUAL HISTORY

On March 5, 2018 appellant, then a 41-year-old city carrier assistant, filed a traumatic 

injury claim (Form CA-1) alleging that, on February 5, 2018, he fell while casing his route in the 

performance of duty. He indicated that he lost consciousness, fell, and hit his head on the cement 

workroom floor and sustaining an open head wound. Appellant stopped work on 

February 5, 2018. On the claim form, the employing establishment indicated that appellant’s 

injury was not sustained in the performance of duty because his injury was caused by a prior illness, 

for which he had been hospitalized for approximately one month prior to his return to work on

February 5, 2018. It also noted that appellant had bragged about the amount of beer he had 

consumed during the Super Bowl. 

With his claim, appellant submitted a March 2, 2018 statement in which he described 

falling on February 5, 2018 and striking his head on the cement floor. He also submitted a March 1, 

2018 work release from Dr. Benjamin J. Saylor, a family practitioner.

3

The record reflects that on February 5, 2018 appellant was transported to the hospital by 

ambulance. In a February 5, 2018 emergency department report, Dr. Eric R. Macrae, a Boardcertified emergency medicine practitioner, noted that appellant had trouble recalling past medical 

history, but noted that he had been recently hospitalized (reason unknown) and had a past history 

of being “knocked unconscious after being hit in head, staples placed.” He indicated that appellant 

had a sudden onset of a syncopal episode while at work putting mailboxes up above him. Appellant 

denied taking any medications regularly, denied any history of seizures, denied family history of 

cardiac dysrhythmias or sudden cardiac death. A computerized tomography (CT) scan4 was 

performed of appellant’s head along with a physical examination. Dr. Macrae provided an 

impression of syncope with altered mental status. Appellant was transferred to another facility for 

further evaluation and a magnetic resonance imaging (MRI) scan. 

In a February 5, 2018 report, Dr. Varsha Pawate, a family medical specialist, noted that 

appellant had a history of anxiety, depression, and chronic lower back pain with radiculopathy and 

presented status post syncope episode at work. Appellant was noted to have some bleeding from 

the site of his fall on the left occipital lobe. Dr. Pawate reviewed the CT scan and indicated that 

this possibly represented subtle calcification or petechial hemorrhage. She provided an impression 

of status post syncope with no preceding symptoms. Dr. Vijay Parthiban, a Board-certified 

internist, cosigned the report.

 

3 The work release indicated that appellant was released to part-time, light-duty work on March 6, 2018 with 

increasing work hours until a return to full duty on March 17, 2018. 

4 The CT scan of appellant’s head showed focal hypodensity within inferior right frontal lobe cortex and subtle 

hyperdensities within the adjacent right frontal cortex which may be subtle calcification or petechial hemorrhage.
3

In a development letter dated March 29, 2018, OWCP advised appellant that additional 

evidence was needed to establish his claim. It informed him of the type of factual and medical 

evidence necessary and provided a questionnaire for his completion. OWCP afforded appellant

30 days to submit the necessary evidence.

On April 5, 2018 appellant completed OWCP’s development questionnaire. He denied 

striking any object on his way down to the floor. Appellant also denied having a history of fainting 

or other medical condition which may have contributed to his injury. 

In a February 8, 2018 hospital discharge report, Dr. Pawate indicated that appellant was 

admitted for syncope and discharged with small right frontal subdural hemorrhage, anxiety and 

depression. The hospital course indicated that CT head showed possible petechial hemorrhages

and magnetic resonance imaging (MRI) brain scan showed minimal linear subdural hemorrhage 

over anterior right frontal lobe. The electroencephalogram (EEG), electrocardiogram (EKG), and 

echocardiogram were normal and did not show a cardiac reason for his syncopal episode. Repeat 

CT head scan did not show a worsening bleed. A copy of a February 6, 2018 brain MRI scan was 

provided.5

In a March 28, 2018 report, Dr. Cynthia L. Costa, a Board-certified neurologist, indicated 

that appellant presented for a history of a head injury. She noted that in 2011 appellant was hit on 

the back of the head and lost consciousness. Appellant reported that he was in an induced coma 

for three days and suffered some cognitive difficulties thereafter. In January 2018, he was 

hospitalized for rhabdomyolysis. In February 2018, appellant had a syncopal episode at work and 

fell straight back, striking his head and losing consciousness. Dr. Costa noted that since the injury 

appellant has had difficulty with headaches, memory (more immediate than long term), focus, 

insomnia, fatigue, and mood. Appellant also had some disequilibrium that has improved. 

Dr. Costa noted that the cause of the syncope was unknown and that the EEG and vascular imaging 

were negative. She provided an assessment of post-concussive syndrome.

In an April 5, 2018 report, Dr. Saylor diagnosed post-concussive syndrome and 

asymptomatic microscopic hematurla. He indicated that other medical conditions appellant had 

included adenoma of right adrenal gland and transaminitis. 

In an April 30, 2018 note, Dr. Costa advised that the reason for appellant’s episode of loss 

of consciousness was unknown, as all the hospital testing was negative. 

By decision dated April 30, 2018, OWCP denied the claim. It found that the medical 

evidence of record was insufficient to establish that appellant’s diagnosed abrasion, postconcussive syndrome, and subdural hemorrhage were caused, aggravated, accelerated, or 

precipitated by the accepted employment incident. 

 

5 The February 6, 2018 brain MRI scan indicated encephalomalacia and gliosis with evidence of prior hemorrhage 

and anterior inferior lateral right frontal lobe compatible with old trauma, and minimal linear subdural hemorrhage 

over anterior right frontal lobe which appeared subacute. 
4

On May 30, 2018 appellant, through counsel, requested an oral hearing before an OWCP 

hearing representative. A telephonic hearing was held on November 15, 2018. 

By decision dated January 30, 2019, an OWCP hearing representative vacated OWCP’s 

April 30, 2018 decision and remanded the case to determine whether appellant’s injury occurred 

in the performance of duty. The hearing representative noted that appellant had been hospitalized 

prior to the claimed injury, but had been released for at least 48 hours. Also appellant had testified 

that he consumed beer in moderation on the day of the Super Bowl. The hearing representative 

noted that the evidence of record made reference to several other factors which may have been 

contributory to the February 5, 2018 event, including the 2011 head injury, the February 7, 2018 

MRI scan findings indicative of old trauma, the hospitalization immediately preceding the work 

event, appellant’s medications, and any effects of the right adrenal gland adenoma and 

transaminitis. The hearing representative determined that OWCP must initiate further 

development with Dr. Costa as to whether any of those items could be considered contributory to 

the cause of the February 5, 2018 syncope and to address how those factors were ruled out as the 

cause of appellant’s syncope. 

In a January 31, 2019 letter, OWCP requested that Dr. Costa review the statement of 

accepted facts (SOAF) and a list of questions and to provide a comprehensive narrative medical 

report with a rationalized medical opinion on the cause of appellant’s syncope. Dr. Costa was 

afforded 30 days to respond. The letter included a note to appellant that he should follow up with

Dr. Costa to insure that a response was received. Both appellant and appellant’s counsel were 

provided a copy of the letter. No further response was received from Dr. Costa.

By decision dated March 7, 2019, OWCP denied the claim, finding that the evidence of 

record was insufficient to establish that appellant’s injury occurred in the performance of duty was 

not established. It advised that Dr. Costa had not provided a comprehensive narrative medical 

report as requested to explain that appellant’s injury was not caused by the outside factors 

identified in hearing representative’s decision. 

On March 12, 2019 appellant, through counsel, requested a telephonic hearing before an 

OWCP hearing representative. A telephonic hearing was held on July 10, 2019. The hearing 

representative noted that she needed appellant’s 2011 hospital records regarding appellant’s coma 

with cognitive difficulties and the hospital records for the time period immediately preceding the 

February 5, 2018 incident. Appellant testified that he had not seen Dr. Costa for some time, but 

he could make an appointment with her office. He also testified that he was hospitalized in 

February 2018, prior to the work incident. The hearing representative left the record open for 30 

days. OWCP received duplicative evidence. 

By decision dated September 13, 2019, an OWCP hearing representative affirmed OWCP’s 

March 7, 2019 decision, finding that that appellant had not met his burden of proof to establish 

that he sustained an injury in the performance of duty. 
5

LEGAL PRECEDENT

An employee seeking benefits under FECA6 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,7that 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.8 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.9

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.10 Fact 

of injury consists of two components that must be considered in conjunction with one another.

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.11 Second, the employee 

must submit sufficient evidence to establish that the employment incident caused a personal 

injury.12

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. However, as 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.14

 

6

Id.

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

153 (1989).

8

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

ECAB 312 (1988).

9 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).

10 D.B., Docket No. 18-1348 (issued January 4, 2019); T.H., 59 ECAB 388, 393-94 (2008).

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

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

13 A.B., Docket No. 17-1689 (issued December 4, 2018); L.G., Docket No. 13-0927 (issued August 27, 2013); 

Carol A. Lyles, 57 ECAB 265 (2005).

14 A.B., id.; M.M., Docket No. 08-1510 (issued November 25, 2008).
6

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.15 OWCP has the burden of proof to submit medical evidence showing the existence 

of a personal, nonoccupational pathology if it chooses to make a finding that a given fall is 

idiopathic in nature.16 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 proven that a physical condition preexisted and 

caused the fall.17

ANALYSIS

The Board finds that this case is not in posture for decision.

In determining whether appellant’s injury occurred in the performance of duty, the Board 

must first consider factors to determine whether the February 5, 2018 incident was caused by an 

idiopathic fall. Factors to be considered include whether there is evidence of a preexisting

condition that caused appellant to collapse, whether there were any intervening circumstances or 

conditions that contributed to his fall, and whether appellant struck any part of his body against a 

wall, piece of equipment, furniture, or similar object as he fell.18 In L.J.,19 the Board found that 

OWCP failed to establish that a fall was idiopathic in nature because the medical evidence of 

record failed to establish that the employee’s fall was solely the result of a nonoccupational 

orthostatic hypotension condition. The Board has also previously explained in A.B.,

20 that “if the 

record does not establish that a 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 was preexisting and caused the fall.”

Similarly, herein, the Board finds that the medical evidence of record fails to establish that 

appellant’s fall was solely the result of a personal, nonoccupational pathology.21 The medical 

evidence noted that appellant was standing casing/putting mail in boxes up above him when he 

fell. Appellant denied striking any object on his way down to the floor. The medical evidence 

related to his hospitalization on February 5, 2018 was submitted to the record and did not establish 

 

15 Dora J. Ward, 43 ECAB 767 (1992); Fay Leiter, 35 ECAB 176 (1983).

16 A.B., supra note 13; P.P., Docket No. 15-0522 (issued June 1, 2016).

17 See D.T., Docket No. 19-1486 (issued January 17, 2020); P.N., Docket No. 17-1283 (issued April 5, 2018); 

John R. Black, 49 ECAB 624 (1998); Judy Bryant, 40 ECAB 207 (1988); Martha G. List, 26 ECAB 200 (1974).

18 See D.T., Docket No. 19-1486 (issued January 17, 2020); A.B., supra note 13; P.P., Docket No. 15-0522 (issued 

June 1, 2016); see also Jennifer Atkerson, 55 ECAB 317 (2004).

19 Docket No. 08-1415 (issued December 22, 2008).

20 Supra note 13. 

21 See D.M., Docket No. 18-1552 (issued June 2, 2020). 
7

any cause for appellant’s fall. Dr. Costa reported in an April 30, 2018 note that the reason for 

appellant’s episode of loss of consciousness was unknown, as all the hospital testing was negative. 

Because appellant denied any intervention or contribution by some hazard or special 

condition of the employment, OWCP undertook further development to address whether his fall 

at work on February 5, 2018 was idiopathic or unexplained. It requested his medical records 

regarding his hospitalization immediately prior to his return to duty on February 5, 2018 as well 

as comprehensive medical report from Dr. Costa which explained whether any of appellant’s past 

circumstances (i.e., 2011 head injury and induced coma, February 2018 MRI scan findings 

indicative of old trauma, appellant’s hospitalization immediately preceding the work incident, 

potential side effects of appellant’s medications, and any effects of the right adrenal gland adenoma 

and transaminitis) contributed to his fall on February 5, 2018. However, despite OWCP’s 

requests, the record remains devoid of this information. The mere fact that an employee has a 

preexisting medical condition, without supporting medical rationale to establish that it was the 

cause of the employment incident, is insufficient to establish that a fall is idiopathic.22 The record 

at hand does not establish that the February 5, 2018 fall was due to an idiopathic condition; thus, 

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.23 The Board 

finds that OWCP has failed to meet its burden to establish that appellant’s fall while standing and 

casing at work was of an idiopathic nature with no contribution or intervention from employment 

factors.24 The evidence of record is sufficient to require OWCP to further develop the medical 

evidence and the case record.25

Accordingly, the case will be remanded for OWCP to determine whether appellant 

sustained an injury causally related to the February 5, 2018 employment incident, and if so, to also 

determine the nature and extent of disability, if any.

CONCLUSION

The Board finds that this case is not in posture for decision.

 

22 D.M., id.; A.B., supra note 13.

23 H.B., Docket No. 18-0278 (issued June 20, 2018).

24 A.B., supra note 13; R.D., Docket No. 13-1854 (issued December 23, 2014).

25 A.B., supra note 13; see Robert A. Redmond, 40 ECAB 796, 801 (1989).
8

ORDER

IT IS HEREBY ORDERED THAT the September 13, 2019 decision of the Office of 

Workers’ Compensation Programs is set aside and the case is remanded to OWCP for further 

proceedings consistent with this decision of the Board.

Issued: December 2, 2020

Washington, DC

Christopher J. Godfrey, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board