United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

A.K., Appellant

and

DEPARTMENT OF VETERANS AFFAIRS, 

WEST LOS ANGELES VETERANS 

ADMINISTRATION MEDICAL CENTER, 

Los Angeles, CA, Employer

__________________________________________

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Docket No. 19-0988

Issued: November 4, 2019

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

JANICE B. ASKIN, Judge

ALEC J. KOROMILAS, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On April 4, 2019 appellant filed a timely appeal from a January 4, 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

 

1 5 U.S.C. § 8101 et seq.

2 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

ISSUE

The issue is whether appellant has met her burden of proof to establish a back condition

causally related to her accepted October 9, 2018 employment incident.

FACTUAL HISTORY

On October 11, 2018 appellant, then a 54-year-old vocational nurse, filed a traumatic injury 

claim (Form CA-1) alleging that on October 9, 2018 she sustained an injury to her lower back 

when she was helping place a patient from a gurney into his wheelchair while in the performance 

of duty. She did not stop work. The employing establishment controverted the claim contending 

that an investigation of the incident did not support appellant’s statements because the patient was 

able to assist in his transfer to the wheelchair and a witness provided an account inconsistent with 

appellant’s statements.

In a development letter dated November 27, 2018, OWCP advised appellant that additional 

factual and medical evidence was necessary to establish her claim. It specifically requested that 

she submit a medical report from her attending physician which provided a diagnosis and an 

opinion, supported by medical rationale, as to how the reported employment incident caused or 

aggravated a medical condition. OWCP also provided a questionnaire for completion and afforded 

appellant 30 days to submit the necessary evidence. Appellant did not submit any additional 

evidence.

By decision dated January 4, 2019, OWCP accepted that the incident occurred as alleged, 

but denied appellant’s claim finding that she had not submitted any medical evidence containing 

a medical diagnosis in connection with the October 9, 2018 employment incident. It concluded, 

therefore, that the requirements had not been met to establish an injury as defined by FECA.

LEGAL PRECEDENT

A claimant seeking benefits under FECA3 has the burden of proof to establish the essential 

elements of his or her claim by the weight of the reliable, probative, and substantial evidence, 

including the fact that the individual is an employee of the United States within the meaning of 

FECA, that the claim was filed within the applicable time limitation, that an injury was sustained 

in the performance of duty as alleged, and that any specific condition or disability 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 on a traumatic injury or an 

occupational disease.5

 

3 Supra note 1.

4 20 C.F.R. § 10.115(e), (f); R.M., Docket No. 18-1281 (issued March 6, 2019); see Jacquelyn L. Oliver, 48 ECAB 

232, 235-36 (1996).

5 S.G., Docket No. 18-1373 (issued February 12, 2019); Michael E. Smith, 50 ECAB 313 (1999).
3

To determine if an employee sustained a traumatic injury in the performance of duty, 

OWCP begins with an analysis of whether fact of injury has been established.6 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.7 The second component is whether the employment incident caused a personal injury.8 

An employee may establish that an injury occurred in the performance of duty as alleged, but fail 

to establish that the disability or specific condition for which compensation is being claimed is 

causally related to the accepted incident.9

Causal relationship is a medical issue, and the medical evidence required to establish causal 

relationship is rationalized medical evidence.10 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 factors identified by the employee.11 

Neither the mere fact that a disease or condition manifests itself during a period of employment, 

nor the belief that the disease or condition was caused or aggravated by employment factors or 

incidents is sufficient to establish causal relationship.12

ANALYSIS

The Board finds that appellant has not met her burden of proof to establish a back condition

causally related to the accepted October 9, 2018 employment incident.

The Board finds that appellant has not submitted medical evidence from a physician 

containing a diagnosis in connection with the October 9, 2018 employment incident.13 The only 

evidence appellant submitted to the record was her completed Form CA-1. OWCP advised 

appellant in a November 27, 2018 development letter that further medical evidence was necessary 

to establish her claim. It also afforded her an opportunity to submit a narrative medical report 

from her physician, which included a diagnosis and an opinion regarding causal relationship.14 

 

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

7 C.L., Docket No. 18-1732 (issued April 2, 2019); D.S., Docket No. 17-1422 (issued November 9, 2017); Elaine 

Pendleton, 40 ECAB 1143 (1989).

8 C.L., id.; R.M., supra note 4; B.M., Docket No. 17-0796 (issued July 5, 2018); John J. Carlone, 41 ECAB 

354 (1989).

9 D.D., Docket No. 18-0648 (issued October 15, 2018); Shirley A. Temple, 48 ECAB 404, 407 (1997).

10 G.N., Docket No. 18-0403 (issued September 13, 2018); Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000).

11 E.V., Docket No. 18-1617 (issued February 26, 2019); see also Leslie C. Moore, 52 ECAB 132 (2000); Gary L. 

Fowler, 45 ECAB 365 (1994).

12 T.H., Docket No. 18-1736 (issued March 13, 2019); Dennis M. Mascarenas, 49 ECAB 215 (1997).

13 C.L., supra note 7; see E.B., Docket No. 18-0014 (issued July 12, 2018); L.F., Docket No. 17-1511 (issued 

November 28, 2017); J.P., Docket No. 14-0087 (issued March 14, 2014).

14 See A.F., Docket No. 17-1374 (issued March 19, 2019).
4

However, appellant did not respond to this request. She has the burden of proof to submit 

rationalized medical evidence establishing that a diagnosed medical condition was causally related 

to the accepted November 5, 2018 employment incident.15 Appellant has not submitted such 

evidence and thus has not met her burden of proof.

Appellant may submit new evidence or argument with a written request for reconsideration 

to OWCP within one year of this 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 her burden of proof to establish a back condition 

causally related to the accepted October 9, 2018 employment incident.

ORDER

IT IS HEREBY ORDERED THAT the January 4, 2019 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: November 4, 2019

Washington, DC

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

 

15 See R.C., Docket No. 18-1639 (issued February 26, 2019).