United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

N.A., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Miami, FL, Employer

__________________________________________

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Docket No. 21-0773

Issued: December 28, 2021

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

JANICE B. ASKIN, Judge

PATRICIA H. FITZGERALD, Alternate Judge

JURISDICTION

On April 27, 2021 appellant filed a timely appeal from an April 19, 2021 merit decision of 

the Office of Workers’ Compensation Programs (OWCP).1 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.

ISSUE

The issue is whether appellant has met her burden of proof to establish a traumatic injury 

in the performance of duty on November 19, 2020, as alleged. 

1 The Board notes that, following the April 19, 2021 decision, OWCP received additional evidence. 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

5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY

On December 3, 2020 appellant, then a 56-year-old postal employee, filed a traumatic 

injury claim (Form CA-1) alleging that on November 19, 2020 she tripped over straps after exiting 

her vehicle and suffered from contusions to both knees and her left hand. On the reverse side of 

the claim form, appellant’s supervisor acknowledged that she was injured in the performance of 

duty. 

On November 19, 2020 the employing establishment issued an authorization for 

examination and/or treatment (Form CA-16) wherein appellant’s history of injury regarding a fall 

after exiting a vehicle was noted. 

In a development letter dated December 10, 2020, OWCP informed appellant that 

additional factual and medical evidence was necessary to establish her claim. It advised her of the 

type of factual and medical evidence needed and provided a questionnaire for her completion. 

OWCP afforded appellant 30 days to submit the necessary evidence. 

Appellant submitted several reports dated December 7, 2020 from Dr. Mauricio F. Herrera, 

Board-certified in orthopedic sports medicine. Dr. Herrera related that she fell at work onto both 

knees on November 19, 2020 and that she sought treatment at the emergency room the following 

day. He diagnosed: osteoarthritis, right and left knee; effusion, right knee; osteophyte, left knee; 

and bursitis of knee, left knee and indicated that appellant’s conditions were work related.

By decision dated April 19, 2021, OWCP denied appellant’s claim, finding that the 

evidence of record was insufficient to establish that the November 19, 2020 incident occurred as 

alleged. It noted that she had not provided a detailed statement in response to its development 

letter. 

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 

3

Id.

4 F.H., Docket No. 18-0869 (issued January 29, 2020); J.P., Docket No. 19-0129 (issued April26, 2019); JoeD. 

Cameron, 41 ECAB 153 (1989).
3

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 and place, and in the manner alleged. The 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 of establishing 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. 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 met her burden of proof to establish an employment 

incident in the performance of duty on November 19, 2020, as alleged. 

As noted, an employee’s statement alleging that an injury occurred at a given time and 

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

persuasive evidence.10 Appellant alleged that she sustained an injury to her left and right knees on 

November 19, 2020 when she tripped and fell after exiting her employing establishment vehicle. 

The employing establishment issued a Form CA-16 on November 19, 2020 where her history of 

injury was noted. Additionally, appellant sought medical care on December 7, 2020 with

Dr. Herrera. He noted her history of injury on November 19, 2020 and diagnosed bilateral knee 

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); 

DeloresC. 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 April9, 2019).

9

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

10 See id.
4

osteoarthritis, right knee effusion, left knee osteophyte and bursitis. The injuries appellant claimed 

are consistent with the facts and circumstances she set forth, her actions, and the medical evidence 

she submitted. The Board thus finds that she has met her burden of proof to establish an 

employment incident in the performance of duty on November 19, 2020, as alleged. 

As appellant has established that the November 19, 2020 employment incident factually 

occurred as alleged, the question becomes whether the incident caused an injury. 11 As OWCP 

found that appellant had not established fact of injury, it has not evaluated the medical evidence.

The Board will, therefore, set aside OWCP’s April 19, 2021 decision and remand the case for 

consideration of the medical evidence of record.12 After this and other such further development 

as deemed necessary, OWCP shall issue a de novo decision addressing whether appellant has met 

her burden of proof to establish an injury causally related to the accepted November 19, 2020 

employment incident.13

CONCLUSION

The Board finds that appellant has met her burden of proof to establish an employment 

incident in the performance of duty on November 19, 2020, as alleged. The Board further finds 

that the case is not in posture for decision regarding whether the medical evidence is sufficient to 

establish an injury causally related to the November 19, 2020 employment incident. 

11 See M.H., Docket No, 20-0576 (issued August6, 2020); M.A.,Docket No. 19-0616 (issued April10, 2020);

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

12 M.H., id.; S.M., Docket No. 16-0875 (issued December 12, 2017).

13 The Board notes that the employing establishment issued a Form CA-16, dated November 19, 2020. 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); V.S.,Docket No. 20-1034 (issued November 25, 2020); J.G.,Docket No. 17-1062 (issued February 13, 

2018); Tracy P. Spillane, 54 ECAB 608 (2003).
5

ORDER

IT IS HEREBY ORDERED THAT the April 19, 2021 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: December 28, 2021

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board