United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

G.W., Appellant

and

DEPARTMENT OF THE INTERIOR, BUREAU 

OF INDIAN AFFAIRS, Neopit, WI, Employer

__________________________________________

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Docket No. 19-0260

Issued: July 10, 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

CHRISTOPHER J. GODFREY, Deputy Chief Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On November 15, 2018 appellant filed a timely appeal from an August 10, 2018 merit 

decision and an October 4, 2018 nonmerit decision of the Office of Workers’ Compensation 

Programs (OWCP).1 Pursuant to the Federal Employees’ Compensation Act2and 20 C.F.R. 

§§ 501.2(c) and 501.3, the Board has jurisdiction over the merits of this case.3

 

1 The Board notes that, during the pendency of this appeal, OWCP issued an August 15, 2019 decision which denied 

modification of the August 10, 2018 denial of the claim. The Board and OWCP may not simultaneously exercise 

jurisdiction over the same issue(s). 20 C.F.R. §§ 501.2(c)(3), 10.626; see J.W., Docket No. 19-1688, n.1 (issued 

March 18, 2020); J.A., Docket No. 19-0981, n.2 (issued December 30, 2019); Arlonia B. Taylor, 44 ECAB 591 (1993);

Douglas E. Billings, 41 ECAB 880 (1990). Consequently, OWCP’s August 15, 2019 decision is set aside as null and 

void.

2 5 U.S.C. § 8101 et seq.

3 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

ISSUES

The issues are: (1) whether appellant has met his burden of proof to establish a traumatic 

injury causally related to the accepted March 6, 2018 employment incident; and (2) whether 

OWCP properly denied appellant’s request for reconsideration of the merits of his claim pursuant 

to 5 U.S.C. § 8128(a).

FACTUAL HISTORY

On March 7, 2018 appellant, then a 58-year-old truck driver, filed a traumatic injury claim 

(Form CA-1) alleging that on March 6, 2018 he injured his back, lacerated his ear, and bumped 

his head as a result of a motor vehicle accident (MVA) while in the performance of duty. He 

indicated that the truck he was driving jackknifed rounding a corner. On the reverse side of the 

form the employing establishment acknowledged that appellant was in the performance of duty at 

the time of the MVA. 

In a first report of injury/illness form dated March 7, 2018, appellant described the incident 

of March 6, 2018, noting that his truck had jackknifed on a slippery road. He advised that he had 

sustained a lacerated ear, bumps, bruises, and a possible back injury as a result of the MVA. 

Appellant provided a form indicating that he had refused medical treatment offered by the 

employing establishment. The form specified that he had been taken by ambulance to a medical 

facility. 

In a development letter dated July 10, 2018, OWCP informed appellant that he had not 

submitted sufficient evidence to establish his claim. It advised him of the type of factual and 

medical evidence needed and provided a questionnaire for his completion. OWCP afforded 

appellant 30 days to submit additional evidence and respond to its inquiries. No further evidence 

was received.

By decision dated August 10, 2018, OWCP denied appellant’s traumatic injury claim 

finding that he had not submitted medical evidence containing a medical diagnosis in connection 

with the accepted March 6, 2018 employment incident. It concluded, therefore, that the 

requirements had not been met to establish an injury as defined by FECA. 

On September 10, 2018 appellant requested reconsideration. In a statement dated

August 23, 2018, he indicated that he had submitted paperwork to the employing establishment’s

Human Resources Department. Appellant advised that he was only requesting payment of medical 

expenses, noting that he had not been injured in the accident. He described the incident of March 6, 

2018 and asserted that he had enclosed copies of medical records.4 

By decision dated October 4, 2018, OWCP denied appellant’s request for reconsideration 

of the merits of his claim pursuant to 5 U.S.C. § 8128(a). 

 

4 On September 25, 2018 appellant again requested reconsideration of the decision of August 10, 2018. 
3

LEGAL PRECEDENT -- ISSUE 1

An employee seeking benefits under FECA5 has the burden of proof to establish the 

essential elements of his or her claim, including 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,6that 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.7 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.8 

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

performance of duty, it first must be determined whether fact of injury has been established.9 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.10 The second component is whether employment incident caused a personal 

injury.11 

Causal relationship is a medical issue and the medical evidence generally required to 

establish causal relationship is rationalized medical opinion evidence. 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 incident.12

ANALYSIS -- ISSUE 1

The Board finds that appellant has met his burden of proof to establish an ear laceration 

and contusions causally related to the accepted March 6, 2018 employment incident.

Appellant sustained injury as a result of a March 6, 2018 MVA and required emergency 

transportation and treatment. OWCP procedures provide that in cases where there is a serious 

injury from an MVA, amongst other types of incidents, and the employing establishment does not 

dispute the facts of the incident alleged, that the claim may be accepted for conditions even without 

 

5

Id.

6

J.W., Docket No. 18-0678 (issued March 3, 2020); S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59 

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

7

J.S., Docket No.18-0657 (issued February 26, 2020); J.M., Docket No. 17-0284 (issued February 7, 2018); 

James E. Chadden, Sr., 40 ECAB 312 (1988).

8 R.R., Docket No.18-0914 (issued February 24, 2020); Delores C. Ellyett, 41 ECAB 992 (1990).

9 S.S., Docket No. 18-1488 (issued March 11, 2019); T.H., 59 ECAB 388 (2008).

10 E.M., Docket No. 18-1599 (issued March 7, 2019); Bonnie A. Contreras, 57 ECAB 364 (2006).

11 Id.

12 See S.S., supra note 9; H.B., Docket No. 18-0781 (issued September 5, 2018).
4

a medical report with other more serious conditions being developed through obtaining medical 

evidence.13 OWCP procedures further provide that, if all of the following criteria are satisfied, a 

claim may be accepted without a medical report: (1) The condition reported is a minor one which 

can be identified on visual inspection by a lay person (e.g., burn, laceration, insect sting, or animal 

bite); (2) The injury was witnessed or reported promptly, and no dispute exists as to the fact of 

injury; and (3) No time was lost from work due to disability.14

The accepted incident was an MVA in which appellant’s truck jackknifed on a slippery 

road which left appellant injured and in need of emergency medical services. Upon obtaining 

emergency medical treatment, it was noted that he sustained an ear laceration and contusions. 

Appellant also complained of back pain. The record provides a consistent history of injury upon 

which no dispute exists, and the employing establishment acknowledged that the MVA occurred 

in the performance of duty, as alleged. Appellant has not alleged time loss from employment 

following the accident, but has sought reimbursement for the medical costs associated with 

transportation and treatment. The Board finds that this evidence is sufficient to establish that 

appellant sustained an ear laceration and contusions causally related to the accepted March 6, 2018

employment incident. The Board further finds that he has not submitted sufficient medical 

evidence to support any back injury or other condition. 

As appellant has established an ear laceration and contusions as accepted employmentrelated conditions in his claim, the Board will reverse the August 10, 2018 decision and remand 

the case for payment of medical transportation and treatment costs.

15

CONCLUSION

The Board finds that appellant has met his burden of proof to establish an ear laceration 

and contusions causally related to the accepted March 6, 2018 employment incident. 

 

13 See Federal (FECA) Procedure Manual, Part 2 -- Claims, Initial Development of Claims, Chapter 2.800.6

(June 2011). See also R.E., Docket No. 18-0515 (issued February 18, 2020).

14 See id. at Chapter 2.805.3(c) (January 2013). See also L.T., Docket No. 15-1922 (issued August 23, 2016).

15 Based upon the disposition of issue 1, issue 2 is rendered moot.
5

ORDER

IT IS HEREBY ORDERED THAT the October 4 and August 10, 2018 decisions are 

reversed and the case is remanded for further proceedings consistent with this decision of the 

Board.

Issued: July 10, 2020

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Christopher J. Godfrey, Deputy Chief Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board