United States Department of Labor

Employees’ Compensation Appeals Board

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J.W., Appellant

and

SOCIAL SECURITY ADMINISTRATION, 

Chicago, IL, Employer

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Docket No. 20-0155

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

JANICE B. ASKIN, Judge

PATRICIA H. FITZGERALD, Alternate Judge

JURISDICTION

On October 26, 2019 appellant filed a timely appeal from a July 19, 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 diagnosed medical 

condition causally related to the accepted March 30, 2018 employment incident.

FACTUAL HISTORY

On April 6, 2018 appellant, then a 34-year-old claim specialist, filed a traumatic injury 

claim (Form CA-1) alleging that on March 30, 2018 he sustained an injury to his back when he 

attempted to sit down in a chair, but the chair slipped from under him causing him to fall to the 

ground while in the performance of duty. He explained that he hit the right side of his back on the 

 

1 5 U.S.C. § 8101 et seq.
2

ground when he fell which caused swelling and tightness in his back. Appellant stopped work on 

that day.

In support of his claim, appellant submitted a continuation of pay nurse report dated 

April 18, 2018, noting that he stopped work on March 30, 2018 as he was totally disabled.

In an April 19, 2018 development letter, OWCP informed appellant of the deficiencies of 

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

30 days to submit the necessary evidence.

In an April 3, 2018 work restriction note, Dr. Thomas D. Daum, Board-certified in family 

medicine, reported that appellant had an unspecified illness and excused him from regular-duty 

work until April 18, 2018. 

In an April 16, 2018 report, Dr. Jennifer Wise, a chiropractor, noted that appellant was 

under her care and held him off work for the period April 16 through May 13, 2018. In an April 23, 

2018 report, she noted that he was treated for injuries sustained at work on March 30, 2018. 

Dr. Wise indicated that appellant presented with low back pain with radiculopathy and was unable 

to perform his work duties, as he was unable to sit and had difficulty moving from one position to 

another and walking without assistance.

By decision dated May 31, 2018, OWCP denied appellant’s claim. It found that while he

had established that the employment incident occurred as alleged, the evidence of record was 

insufficient to establish a medical diagnosis in connection with the accepted March 30, 2018 

employment incident. Thus, OWCP concluded that the requirements had not been met to establish 

an injury as defined by FECA.

On April 23, 2019 appellant requested reconsideration. In support of his request, he

submitted a March 30, 2018 report from Dr. Maura Dickinson, Board-certified in emergency 

medicine, who noted that he presented to the emergency department with complaints of back and 

neck pain. Appellant reported that he slipped from a chair at work and fell onto his buttocks which

aggravated his back. Dr. Dickinson conducted a physical examination and found no numbness or 

tingling down appellant’s legs. She noted an impression of back pain and contusion. 

Dr. Dickinson further reviewed his lumbosacral spine x-rays of the same date, which revealed no 

abnormal lumbar spine findings and diagnosed back pain, including differential diagnoses “of 

fracture vs sprain vs contusion.” 

In an April 19, 2019 statement, appellant noted that he submitted a hospital report which 

showed that he suffered from a contusion from his fall. He asserted that his back was swollen for 

weeks and required massage therapy with a chiropractor.

By decision dated July 19, 2019, OWCP denied modification of its prior decision.
3

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. Second component is whether the employment incident 

caused a personal injury and 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

ANALYSIS

The Board finds that appellant has met his burden of proof to establish the diagnosed 

medical condition of a back contusion. The Board further finds, however, that the case in not in 

posture for a decision as to whether his diagnosed contusion is causally related to the accepted 

March 30, 2018 employment incident.

 

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).
4

Dr. Dickinson, in her March 30, 2018 report, described the accepted March 30, 2018 

employment incident, provided examination findings, and noted an impression of a contusion and 

a differential diagnosis of “fracture vs sprain vs contusion.” Therefore, the Board finds that the 

evidence of record establishes the diagnosis of a back contusion.

OWCP has not reviewed the medical evidence of record on the issue of whether the 

established diagnosis of back contusion is causally related to the accepted employment incident. 

Therefore, the case will be remanded to OWCP for consideration of the medical evidence on the 

issue of causal relationship. Following such further development as deemed necessary, OWCP 

shall issue a de novo decision. 

CONCLUSION

The Board finds that appellant has met his burden of proof to establish the diagnosed 

medical condition of a back contusion. The Board further finds that the case is not in posture for 

a decision as to whether his diagnosed back contusion is causally related to the accepted March 30, 

2018 employment incident.

ORDER

IT IS HEREBY ORDERED THAT the July 19, 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

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board