United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

J.C., Appellant

and

DEPARTMENT OF THE ARMY, MEDICAL 

COMMAND, Fort Benning, GA, Employer

__________________________________________

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Docket No. 19-0310

Issued: June 18, 2019

Appearances: Case Submitted on the Record

Alan J. Shapiro, for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

CHRISTOPHER J. GODFREY, Chief Judge

PATRICIA H. FITZGERALD, Deputy Chief Judge

JANICE B. ASKIN, Judge

JURISDICTION

On November 27, 2018 appellant, through counsel, filed a timely appeal from an 

October 3, 2018 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 left upper extremity

conditions causally related to the accepted May 15, 2014 employment incident.

FACTUAL HISTORY

On January 27, 2017 appellant, then a 55-year-old maintenance mechanic, filed a traumatic 

injury claim (Form CA-1) alleging that on “May 14, 2015” he sustained a left elbow injury when 

he was drilling through a concrete wall with a hammer drill which jammed, causing him to 

overextend his left elbow while in the performance of duty.

3

 On the reverse side of the claim form, 

appellant’s supervisor noted that the alleged incident occurred in the performance of duty. 

Appellant did not stop work.

In a development letter dated February 16, 2017, OWCP informed appellant that the 

evidence of record was insufficient to establish his claim. It advised him as to the type of medical 

and factual evidence required to establish his claim and afforded him 30 days to respond.

Appellant submitted medical reports from Dr. Phillip Hajek and Dr. Benjamin Thomas,

Board-certified orthopedic surgeons, from Musculoskeletal Associates (MSA). The quality of 

these reports was extremely poor and much of the content was illegible, including the dates of 

these reports. From what could be deciphered, appellant sought treatment beginning in 

August 2014 due to complaints of left elbow pain from one month prior after he lifted an object 

and felt a snap at his elbow. Dr. Hajek diagnosed left upper extremity pain, left medial 

epicondylitis, left median nerve neuritis, left carpal tunnel syndrome, left cubital tunnel syndrome

and hyperextension. A January 19, 2016 operative report was provided from Dr. Thomas who 

performed left carpal tunnel and cubital tunnel release. Postoperative reports dated through 

April 6, 2016 reflect treatment due to complaints of continued pain and numbness in the left upper 

extremity. In a February 7, 2016 report, Dr. Thomas noted that appellant denied a specific injury,

but that one day at work he was operating a drill and felt that he overextended his elbow.

By letter dated March 9, 2017, the employing establishment controverted the claim, 

contending that appellant failed to submit the required factual and medical evidence.

By decision dated March 24, 2017, OWCP denied appellant’s claim, finding that the 

evidence of record was insufficient to establish a firm medical diagnosis which could be 

reasonably attributed to the accepted May 14, 2015 employment incident.

On April 11, 2017 appellant requested an oral hearing before an OWCP hearing 

representative.

A hearing was held on October 12, 2017 during which appellant testified that his left elbow 

injury occurred around May 15, 2014 and not on May 14, 2015 as reported, explaining that he 

mistakenly wrote the wrong date on his Form CA-1. He testified that he was sure the injury

 

3 While appellant initially alleged that the employment incident occurred on May 14, 2015, by decision dated 

December 13, 2017 an OWCP hearing representative found that the incident occurred on May 15, 2014. 
3

occurred on this date when he was working at a clinic because a backflow preventer was leaking 

water into the basement. Appellant reported standing on a ladder two steps high while holding a 

left-hand drill handle and a coworker was holding the right-hand handle. They were 

hammering/drilling through concrete when the drill bit jammed/stopped, but the motor did not. 

Appellant explained that he could not remove his finger from the trigger before it reversed on his 

left elbow and pushed his arm backwards in the sideways position. He reported that his left elbow 

overextended and snapped. However, appellant continued to work regular duty despite continued 

pain. He reported that he first sought treatment for his left elbow condition on August 1, 2014. 

The hearing representative noted that one of the medical reports in the file made reference to him 

being injured as a result of a lifting incident, however, appellant reported that this was incorrect. 

He noted that he had surgery in January 2015, February 2017, and again in October 2017. The 

first surgery was for his cubital and carpal tunnel, the second surgery was to repair his triceps 

muscle, and the third surgery was done for scar tissue which had formed in the left hand. Appellant 

reported notifying his immediate supervisor on the date of the incident who informed him that he 

would file the necessary paperwork. He explained the delay in filing his claim, noting that his 

supervisor never filed the paperwork and he did not follow-up with him. Appellant noted that 

ultimately, a magnetic resonance imaging (MRI) scan was ordered which revealed a left ruptured 

triceps tendon. He confirmed that there were no other injuries sustained between the time of the 

May 15, 2014 employment incident and the date it was reported on his CA-1 Form. Appellant

was advised of the medical evidence needed in support of his claim and the record was held open 

for 30 days.

By decision dated December 13, 2017, OWCP’s hearing representative affirmed the 

March 24, 2017 decision, as modified. She found that appellant had established firm medical 

diagnoses of left medial epicondylitis, left carpal tunnel syndrome, and left cubital tunnel 

syndrome. The hearing representative further modified the prior decision to reflect the date of 

injury as May 15, 2014, noting the incident was accepted as having occurred as alleged while in 

the performance of duty. She denied the claim for failing to establish causal relationship, finding 

that the evidence of record was insufficient to establish that the diagnosed left elbow conditions 

were causally related to the accepted May 15, 2014 employment incident.

On July 3, 2018 appellant, through counsel, requested reconsideration.4 Counsel noted 

submission of a medical report from Dr. Waldo E. Floyd, III, a Board-certified orthopedic surgeon, 

in support of appellant’s claim.

In an April 3, 2018 report, Dr. Floyd related that appellant was referred to him for an 

evaluation in early 2017 following a left upper extremity MRI scan that demonstrated a rupture of 

the left distal triceps tendon. He noted that appellant had previously been treated nonsurgically. 

On February 1, 2017 appellant was found to have a central rupture of the triceps tendon. Dr. Floyd

noted a history of injury that appellant was holding a drill that torqued causing his elbow to extend 

forcibly and pop. He noted that this history was consistent with appellant’s MRI scan and 

operative findings of a ruptured triceps tendon. Dr. Floyd noted that an incident such as this was

 

4 The record reflects that on March 26, 2018 appellant, through counsel, requested an appeal before the Board. By 

letter dated April 26, 2018, counsel requested that the Board withdraw the appeal filed on March 26, 2018. On 

June 29, 2018 the Board issued an order granting appellant’s request for the dismissal of his appeal. Order Dismissing 

Appeal, Docket No. 18-0916 (issued June 29, 2018).
4

associated with rupture of the distal triceps and he had no other history of an injury that may have 

ruptured his distal triceps. He concluded that the timeline was consistent with the 2015 injury with 

a drill torque, hyperextending his left elbow being the event that ruptured the left distal triceps.

By decision dated October 3, 2018, OWCP denied modification of the December 13, 2017 

decision.

LEGAL PRECEDENT

An employee seeking benefits under FECA 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,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 determine if an employee has sustained a traumatic injury in the performance of duty, 

OWCP begins with an analysis of whether fact of injury has been established. Generally, fact of 

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

first component is whether the employee actually experienced the employment incident that 

allegedly occurred.8 The second component is whether 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

ANALYSIS

The Board finds that appellant has not met his burden of proof to establish left upper 

extremity conditions causally related to the accepted May 15, 2014 employment incident. 

 

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

153 (1989).

6

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 F.P., Docket No. 19-0159 (issued May 7, 2019); Delores C. Ellyett, 41 ECAB 992 (1990).

8 C.B., Docket No. 18-0071 (issued May, 13, 2019); Elaine Pendleton, 40 ECAB 1143 (1989).

9 M.H., Docket No. 18-1737 (issued March 13, 2019); John J. Carlone, 41 ECAB 354 (1989). 

10 S.S., Docket No. 18-1488 (issued March 11, 2019). 
5

In support of his claim, appellant submitted medical reports dated August 1, 2014 through 

April 6, 2016 from Drs. Hajek and Thomas. The Board finds that the reports of Dr. Hajek and

Thomas are not well rationalized. While the physicians provided firm diagnoses of left medial 

epicondylitis, left median nerve neuritis, left carpal tunnel syndrome, and left cubital tunnel 

syndrome, they failed to provide probative rationalized opinion regarding the cause of appellant’s 

conditions. These reports failed to provide a detailed and consistent history of injury pertaining to 

the May 15, 2014 employment incident. Dr. Hajek’s August 1, 2014 report noted a lifting injury 

when appellant felt his elbow snap while Dr. Thomas’ February 1, 2016 report noted complaints 

of left elbow pain for approximately one year, stating that one day at work he was operating a drill 

and felt he overextended his left elbow. Without a proper understanding of the employment 

incident, an opinion on causal relationship is of limited probative value as the physician is unable 

to describe how the incident caused the diagnosed conditions.

11

 The Board has found that a 

physician must provide a narrative description of the identified employment incident and a 

reasoned opinion on whether the employment incident described caused or contributed to 

appellant’s diagnosed medical conditions.12 Therefore, these reports are insufficient to establish 

appellant’s claim.13

Dr. Floyd’s April 3, 2018 report is also insufficient to establish appellant’s traumatic injury 

claim. He noted a history of injury when appellant was holding a drill that torqued, causing him 

to forcibly extend his left elbow which popped. Dr. Floyd opined that the timeline was consistent 

with the 2015 injury when the drill torque hyperextended his left elbow, the event that caused his

ruptured left distal triceps tendon. The Board notes that it does not appear that Dr. Floyd has an 

accurate history of injury as appellant alleged his left elbow condition occurred on May 15, 2014. 

Furthermore, his generalized statements do not establish causal relationship because they merely 

repeat appellant’s allegations and are unsupported by adequate medical rationale explaining how 

this physical activity actually caused the diagnosed condition.14 As Dr. Floyd’s report lacks the 

specificity and detail needed to establish a May 15, 2014 work-related traumatic injury, it is of 

limited probative value.15 

The Board finds that the record lacks rationalized medical evidence establishing causal 

relationship between the accepted May 15, 2014 employment incident and appellant’s diagnosed 

left upper extremity conditions.16 Thus, appellant has not met his burden of proof.

 

11 See L.M., Docket No. 14-0973 (issued August 25, 2014); R.G., Docket No. 14-0113 (issued April 25, 2014); 

K.M., Docket No. 13-1459 (issued December 5, 2013); A.J., Docket No. 12-0548 (issued November 16, 2012).

12 See V.J., Docket No. 17-0358 (issued July 24, 2018); John W. Montoya, 54 ECAB 306 (2003).

13 K.S., Docket No. 18-1781 (issued April 8, 2019).

14 T.W., Docket No. 18-1436 (issued April 10, 2019).

15 P.O., Docket No. 14-1675 (issued December 3, 2015); S.R., Docket No. 12-1098 (issued September 19, 2012).

16 K.L., Docket No. 18-1029 (issued January 9, 2019).
6

Appellant may submit additional evidence, together with a written request for 

reconsideration, to OWCP within one year of the Board’s 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 left upper 

extremity conditions causally related to the accepted May 15, 2014 employment incident. 

ORDER

IT IS HEREBY ORDERED THAT the October 3, 2018 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: June 18, 2019

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board