United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

A.R., Appellant

and

U.S. POSTAL SERVICE, PROCESSING & 

DISTRIBUTION CENTER, New Orleans, LA, 

Employer

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Docket No. 19-1982

Issued: May 18, 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

PATRICIA H. FITZGERALD, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On September 30, 2019 appellant filed a timely appeal from a September 9, 2019 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 his burden of proof to establish that an injury

occurred in the performance of duty on July 7, 2019, as alleged.

 

1 5 U.S.C. § 8101 et seq.

2 The record provided to the Board includes evidence received after OWCP issued its September 9, 2019 

decision. 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 July 7, 2019 appellant, then a 38-year-old postal support employee clerk, filed a 

traumatic injury claim (Form CA-1) alleging that he sustained an injury to his lower back on that 

day at approximately 3:00 a.m. when pushing empty wires for six hours while in the performance 

of duty. On the reverse side of the claim form, appellant’s supervisor indicated that he was not 

present when appellant’s injury occurred, but that, per appellant’s statement, he injured his back 

while in the performance of duty. Appellant stopped work on the date of injury and returned to 

work on July 11, 2019. 

OWCP also received an illegible statement from appellant regarding the alleged July 7, 

2019 incident. 

The record also contains the first page of an authorization for examination and/or treatment 

(Form CA-16) dated July 7, 2019 from the employing establishment, which indicated that 

appellant was authorized to receive treatment for a back injury sustained that day. 

In July 8, 2019 medical report, Dr. Rahul Prasankumar, Board-certified in emergency 

medicine, noted that appellant was treated in the emergency department on July 7, 2019. He

recommended that appellant “return to work after being cleared by a follow-up physician.”

Dr. Prasankumar recommended two days of rest and no heavy lifting until cleared by pain 

management. 

In an unsigned, undated duty status report (Form CA-17), appellant’s supervisor noted an 

injury date of July 7, 2019 as a result of pushing heavy equipment and empty wires. Appellant 

also submitted a continuation of pay (COP) nurse report dated July 22, 2019, noting work 

restrictions for the period July 11 to 17, 2019. 

In a development letter dated July 23, 2019, OWCP informed appellant of the deficiencies 

of his claim. It advised him of the type of factual and medical evidence necessary to establish his 

claim and provided a factual questionnaire for completion. OWCP afforded appellant 30 days to 

respond. 

In an August 2, 2019 Form CA-17, appellant’s supervisor noted that appellant injured his 

lower back after pushing and pulling wires. Dr. Ronald Segura, Board-certified in pain medicine, 

noted that appellant suffered from neck and back pain with radiculopathy. He diagnosed cervical 

and lumbar disc herniations and facet joint syndrome. Dr. Segura provided work restrictions of 

intermittent lifting no more than 10 to 15 pounds and noted that appellant would need a few days 

to recover following various spinal procedures. 

In a medical report of even date, Dr. Segura again noted that appellant sustained multiple 

herniated discs in his cervical and lumbar spine and had been incapacitated from work beginning 

July 18, 2019 as a result of his conditions. He further noted that appellant had undergone several 

spinal procedures to treat his conditions and required time off from work to heal. 

In an August 29, 2019 return to work status report, Mia Trupiano, a nurse practitioner, 

released appellant to work beginning September 1, 2019 with restrictions for pushing and pulling 

no more than 40 pounds. 
3

By decision dated September 9, 2019, OWCP denied appellant’s claim, finding that the 

evidence of record was insufficient to establish that the July 7, 2019 employment incident occurred 

as alleged. It concluded therefore that the requirements had not been met to establish an injury as 

defined by FECA.

LEGAL PRECEDENT

An employee seeking benefits under FECA3 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,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 first must be determined whether fact of injury has been established. There 

are two components involved in establishing fact of injury. 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. Second component is whether the employment incident 

caused a personal injury and can be established only by medical evidence.7 

An injury does not have to be confirmed by eyewitnesses in order to establish the fact that 

an employee sustained an injury in the performance of duty, but the employee’s statements must 

be consistent with the surrounding facts and circumstances and his or her subsequent course of 

action.8 The employee has not met his or her burden of proof to establish the occurrence of an 

injury when there are such inconsistencies in the evidence as to cast serious doubt upon the validity 

of the claim. Such circumstances as late notification of injury, lack of confirmation of injury, 

continuing to work without apparent difficulty following the alleged injury, and failure to obtain 

medical treatment may, if otherwise unexplained, cast serious doubt on an employee’s statements 

in determining whether a case has been established. 

 

3 Supra note 1.

4 F.H., Docket No.18-0869 (issued January 29, 2020); J.P., Docket No. 19-0129 (issued April 26, 2019); Joe D. 

Cameron, 41 ECAB 153 (1989). 

5 L.C., Docket No. 19-1301 (issued January 29, 2020); J.H., Docket No. 18-1637 (issued January 29, 2020); 

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

6 P.A., Docket No. 18-0559 (issued January 29, 2020); K.M., Docket No. 15-1660 (issued September 16, 2016); 

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

7 T.H., Docket No. 19-0599 (issued January 28, 2020); K.L., Docket No. 18-1029 (issued January 9, 2019); John J. 

Carlone, 41 ECAB 354 (1989).

8 See J.M., Docket No. 19-1024 (issued October 18, 2019); M.F., Docket No. 18-1162 (issued April 9, 2019).
4

An employee’s statement alleging that an injury occurred at a given time and in a given 

manner is of great probative value and will stand unless refuted by strong or persuasive evidence.9

ANALYSIS

The Board finds that appellant has established that the July 7, 2019 incident occurred in 

the performance of duty, as alleged.

Appellant filed his traumatic injury claim on July 7, 2019 and indicated that, on that date,

at approximately 3:00 a.m., he sustained a lower back injury as a result of pushing and pulling

empty wires for hours. On the reverse side of the claim form, appellant’s supervisor indicated that,

while he had not witnessed the alleged employment incident, appellant reported to him that he

injured his back that day, while in the performance of duty, in the manner described in his 

statement. He further noted that appellant initially stopped work the same day of the alleged 

employment incident and sought medical treatment that day. 

In a Form CA-16, the employing establishment noted that appellant was injured on July 7, 

2019 the date he alleged that the employment incident occurred, and authorized medical treatment 

for a back injury. Additionally, in Form CA-17s received by OWCP in July and August 2019, the 

employing establishment continued to note appellant’s date of injury as July 7, 2019 and described 

the mechanism of injury as prolonged pushing and pulling of empty wires and heavy equipment, 

which is consistent with his account of the alleged employment incident. 

Additionally, in a medical report dated July 8, 2019, Dr. Prasankumar confirmed that 

appellant was treated in the emergency department on July 7, 2019 the same date in which he 

alleged the employment incident occurred. Further, Dr. Segura repeatedly noted appellant’s 

complaints of neck and low back pain related to a July 7, 2019 employment incident involving 

prolonged pushing and pulling of heavy equipment. He diagnosed cervical and lumbar disc 

herniations and facet joint syndrome and recommended that appellant return to work with 

restrictions following a recovery period. 

The Board finds that appellant’s description on the Form CA-1 and the July 7, 2019 Form 

CA-16 and Form CA-17s are sufficient to establish that the July 7, 2019 employment incident 

occurred at the time, place, and in the manner alleged. Appellant provided a consistent account of 

the mechanism of injury that has not been refuted by evidence contained in the record.10 

As set forth above, a claimant’s statement that an injury occurred at a given time, place, 

and in a given manner is of great probative value and will stand unless refuted by strong or 

 

9 See M.C., Docket No. 18-1278 (issued March 7, 2019); D.B., 58 ECAB 464, 466-67 (2007).

10 See S.W., Docket No. 17-0261 (issued May 24, 2017) (the Board found that OWCP improperly determined that 

the alleged employment incident did not occur when appellant provided consistent accounts of the claimed incident 

and there was no evidence to refute her detailed description); see also J.L., Docket No. 17-1712 (issued 

February 12, 2018).
5

persuasive evidence.11 The Board finds that appellant has established that an employment incident 

occurred in the performance of duty on July 7, 2019 as alleged.

As appellant has established that the July 7, 2019 employment incident factually occurred, 

the question becomes whether this incident caused an injury.12 As OWCP has not evaluated the 

medical evidence of record the case is not in posture for decision with regard to causal relationship 

and must therefore be remanded for consideration of the medical evidence of record. Following 

this and other such further development as is deemed necessary, it shall issue a de novo decision 

addressing whether appellant has met his burden of proof to establish a medical condition causally 

related to the accepted July 7, 2019 employment incident.13

CONCLUSION

The Board finds that appellant has established that an incident occurred in the performance 

of duty on July 7, 2019, as alleged. However, the case is not in posture for decision with regard 

to whether he has established a condition causally related to the accepted July 7, 2019 employment 

incident.14

 

11 A.C., Docket No. 18-1567 (issued April 9, 2019); Gregory J. Reser, 57 ECAB 277 (2005).

12 See C.M., Docket No. 19-0009 (issued May 24, 2019).

13 See Betty J. Smith, 54 ECAB 174 (2002).

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).
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ORDER

IT IS HEREBY ORDERED THAT the September 9, 2019 decision of the Office of 

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

consistent with this decision of the Board.

Issued: May 18, 2020

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board