United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

C.H., Appellant

and

SMITHSONIAN INSTITUTION, PENNSY 

COLLECTIONS & SUPPORT CENTER, 

Landover, MD, Employer

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Docket No. 20-0440

Issued: August 3, 2020

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

JANICE B. ASKIN, Judge

PATRICIA H. FITZGERALD, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On December 19, 2019 appellant filed a timely appeal from an October 15, 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. 

ISSUE

The issue is whether appellant has met his burden of proof to establish a left inguinal hernia

causally related to the accepted March 4, 2019 employment incident. 

FACTUAL HISTORY

On March 6, 2019 appellant, then a 52-year-old exhibition specialist, filed a traumatic 

injury claim (Form CA-1) alleging that on March 4, 2019 he sustained a possible groin hernia

 

1 5 U.S.C. § 8101 et seq.
2

when lifting an acrylic panel while in the performance of duty. On the reverse side of the claim 

form, the employing establishment indicated that he was injured in the performance of duty on 

March 4, 2019. Appellant did not stop work.

A March 28, 2019 letter from the employing establishment noted appellant’s date of injury 

as March 4, 2019 and indicated that he was diagnosed with a hernia and required surgery. It 

requested authorization for the surgery and noted that his continuation of pay (COP) coverage 

would run out prior to his return to work. 

In an April 3, 2019 development letter, OWCP notified appellant that when his claim was 

received it appeared to be a minor injury that resulted in minimal or no lost time from work, and 

since the employing establishment had not controverted COP or challenged the case, a limited 

amount of medical expenses were administratively approved and paid. It noted that it had reopened 

the claim for formal consideration because he had requested authorization for surgery. OWCP 

informed appellant that additional factual and medical evidence were required to establish his 

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

and attached a questionnaire for his completion. OWCP afforded appellant 30 days to submit the 

requested evidence. 

A March 7, 2019 medical report by Dr. Seth Garber, Board-certified in family medicine, 

indicated that appellant stated that he started experiencing left groin pain four days ago right after 

lifting a large sheet of acrylic. Appellant’s pain improved when sitting and resolved when lying 

down. When he woke up the next day, the pain was gone and he had not experienced pain since 

then. Dr. Garber reviewed appellant’s medical history and conducted a physical examination 

which revealed a normal inguinal canal, normal testes, and no hernia. He diagnosed left groin pain

and additionally indicated that appellant may have a groin strain or an inguinal hernia. 

A March 12, 2019 medical report by Dr. Garber indicated that appellant presented with 

abdominal pain and a possible hernia. Appellant related that on that day he pushed something 

heavy at work which caused the pain in the exact same spot in his left groin to return. Dr. Garber 

conducted a physical examination which revealed no abdominal tenderness, a normal inguinal 

canal, and no hernia. He diagnosed left groin pain and opined that appellant could have strained a 

muscle, but he was highly suspicious that appellant sustained a hernia. 

On April 15, 2019 appellant completed OWCP questionnaire and related that on March 4, 

2019 he was installing cases for an exhibit when he lifted a large acrylic panel that was 

approximately 70 pounds and felt a sharp pain in his lower left groin. He then moved the panel to 

its former place with assistance and sat down until the extreme pain subsided. Appellant noted 

that his pain subsided the next day, and he stated that he did not sustain any other injuries between 

the date of his injury and the date his injury was first report to his supervisor or physician. He 

related that he did not have any similar symptoms or conditions prior to his workplace injury. 

By decision dated May 6, 2019, OWCP denied appellant’s traumatic injury claim, finding 

that the evidence of record was insufficient to establish a diagnosed condition in connection with 

the accepted March 4, 2019 employment incident. It concluded therefore that the requirements 

had not been met to establish an injury as defined by FECA. 
3

In a March 28, 2019 letter to Dr. Garber, Dr. Mohammed Kalan, a Board-certified surgeon, 

indicated that appellant presented that day with intermittent pain in a specific spot behind 

appellant’s left testicle that was associated with and aggravated by strenuous activity. He noted 

that an examination revealed no evidence of an inguinal hernia and there was no obvious testicular 

pathology. Dr. Kalan indicated that he suspected that appellant’s pain was due to a pulled muscle 

or ligament. 

An April 16, 2019 ultrasound report by Dr. Kalan indicated that a limited ultrasound 

examination was performed on the area of pain in appellant’s left groin. It revealed a discrete 

fascial defect on the floor in the left inguinal canal measuring about 6.2 mm, consistent with a left

inguinal hernia. Dr. Kalan’s impression indicated that the ultrasound displayed a reducible left 

inguinal hernia. 

A June 10, 2019 letter by Dr. Kalan indicated that appellant was scheduled to undergo 

surgery to repair his left inguinal hernia on June 26, 2019. He stated that appellant must be off of 

work for the week after his surgery, and then upon his return to work he should be on light duty 

and only lift 20 pounds or less for 5 to 7 weeks. Dr. Kalan indicated that after that period appellant

could return to full-duty work. 

On July 23, 2019 appellant requested reconsideration. 

A July 19, 2019 letter by Dr. Kalan indicated that on March 28, 2019 appellant presented 

with left groin pain that started four days ago due to lifting a heavy acrylic panel at work. He did 

not find an inguinal hernia upon physical examination so he ordered an ultrasound, and the 

ultrasound demonstrated that appellant had a left inguinal hernia. Dr. Kalan explained that most 

inguinal hernias in men are present since birth, but do not manifest until an event of high intraabdominal pressure, such as lifting something heavy. He opined that, due to the nature of inguinal 

hernias, it is impossible to definitively say that appellant’s hernia was caused when he lifted a 

heavy item. Dr. Kalan stated that he could “say with some confidence” that appellant had a 

disposition for developing a mature hernia since birth, and the heavy lift of the acrylic panel was 

the event that caused the hernia to be pushed out of appellant’s groin and manifest, which caused 

his pain. He stated that it was impossible to know for certain when appellant first had the hernia, 

but his own explanation is a very reasonable and likely explanation of appellant’s history of injury. 

Dr. Kalan related that he conducted surgery on appellant on July 1, 2019 and he indicated that at 

that time he was able to confirm that appellant had a hernia. 

By decision dated October 15, 2019, OWCP modified its May 6, 2019 decision, finding 

that the evidence of record was sufficient to establish a diagnosed condition. However, it 

continued to deny the claim, as the evidence of record was insufficient to establish causal 

relationship between appellant’s diagnosed condition and the accepted March 4, 2019 employment 

incident. 
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LEGAL PRECEDENT

An employee seeking benefits under FECA2 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,3that 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.4 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.5

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. The second component is whether the employment incident 

caused a personal injury and this component can be established only by medical evidence.6

The medical evidence required to establish a causal relationship between a claimed specific 

condition and an employment incident is rationalized medical opinion evidence.7 The opinion of 

the physician must be based on a complete factual and medical background of the employee, 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 specific employment factors 

identified by the employee.8

In a case where a preexisting condition involving the same part of the body is present and 

the issue of causal relationship therefore involves aggravation, acceleration, or precipitation, the 

 

2

Id.

3 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).

4 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).

5 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).

6 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).

7 S.S., Docket No. 19-0688 (issued January 24, 2020); A.M., Docket No. 18-1748 (issued April 24, 2019); Robert G. 

Morris, 48 ECAB 238 (1996).

8 T.L., Docket No. 18-0778 (issued January 22, 2020); Y.S., Docket No. 18-0366 (issued January 22, 2020); 

Victor J. Woodhams, 41 ECAB 345, 352 (1989).
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physician must provide a rationalized medical opinion that differentiates between the effects of the 

work-related injury or disease and the preexisting condition.9

ANALYSIS

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

Appellant alleged that he sustained an injury on March 4, 2019 while lifting an acrylic 

panel in the performance of duty. OWCP has accepted that the March 4, 2019 incident occurred 

as alleged. Dr. Kalan’s July 19, 2019 letter indicated that appellant presented with left groin pain 

due to lifting a heavy acrylic panel at work. He conducted a physical examination and reviewed 

an ultrasound which revealed a left inguinal hernia. Dr. Kalan explained that most inguinal hernias 

in men are present since birth, but do not manifest until an event of high intra-abdominal pressure, 

such as lifting something heavy. He opined that appellant had a disposition for developing a 

mature hernia since birth, and the heavy lift of the acrylic panel was the event that caused the 

hernia to be pushed out of appellant’s groin and manifest.

It is well established that proceedings under FECA are not adversarial in nature, nor is 

OWCP a disinterested arbiter. While the claimant has the burden of proof to establish entitlement 

to compensation, OWCP shares the responsibility in the development of the evidence to see that 

justice is done.10

Dr. Kalan is a Board-certified orthopedic surgeon who is qualified in his field of medicine 

to render rationalized opinions on the issue of causal relationship, and he provided a 

comprehensive understanding of the claimed mechanism of injury. He related that inguinal hernias 

in men were typically present at birth, however lifting a heavy object, like the acrylic panel 

appellant lifted at work, pushed the hernia out of his groin and manifest the hernia. The Board 

finds that, although his July 19, 2019 medical report is insufficiently rationalized to meet

appellant’s burden of proof to establish his claim, it does explains a physiological process by which

the accepted incident could have caused or aggravated the diagnosed hernia condition. Dr. Kalan’s 

July 19, 2019 medical report therefore raises an uncontroverted inference of causal relationship

between appellant’s claimed hernia condition and the accepted employment incident. Further,

development of appellant’s claim is therefore required.11

On remand OWCP shall prepare a statement of accepted facts setting forth the accepted 

employment incident and refer appellant to an appropriate second opinion physician for an 

examination and a rationalized medical opinion as to whether the accepted employment incident

either caused or aggravated the diagnosed hernia condition.12 If the second opinion physician 

 

9 Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.805.3e (January 2013); V.W.,

Docket No. 19-1537 (issued May 13, 2020); N.C., Docket No. 19-1191 (issued December 19, 2019); R.D., Docket 

No. 18-1551 (issued March 1, 2019).

10 Y.D., Docket No. 19-1200 (issued April 6, 2020).

11 See K.T., Docket No 19-1436 (issued February 21, 2020).

12 Supra note 9 at Chapter 2.805.3e (January 2013). See R.D., Docket No. 18-1551 (issued March 1, 2019).
6

disagrees with the pathophysiological explanation provided by Dr. Kalan, he or she must provide 

a fully-rationalized explanation explaining why Dr. Kalan’s opinion is unsupported. After this and 

other such further development deemed necessary, OWCP shall issue a de novo decision.

CONCLUSION

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

ORDER

IT IS HEREBY ORDERED THAT the October 15, 2019 decision of the Office of 

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

consistent with this decision of the Board. 

Issued: August 3, 2020

Washington, DC

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board