United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

E.L., Appellant

and

DEPARTMENT OF AGRICULTURE, U.S. 

FOREST SERVICE, Corona, CA, Employer

__________________________________________

)

)

)

)

)

)

)

)

Docket No. 21-0587

Issued: July 6, 2022

Appearances: Case Submitted on the Record

Stephanie N. Leet, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

PATRICIA H. FITZGERALD, Deputy Chief Judge

JANICE B. ASKIN, Judge

JURISDICTION

On March 3, 2021 appellant, through counsel, filed a timely appeal from a February 12,

2021 merit decision of the Office of Workers’ Compensation Programs (OWCP). 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.

1

In all cases in which a representative has been authorized in a matter before the Board, no claim for a fee for legal 

or other service performed on appeal before the Board is valid unless approved by the Board. 20 C.F.R. § 501.9(e). 

No contract for a stipulated fee or on a contingent fee basis will be approved by the Board. Id. An attorney or 

representative’s collection of a fee without the Board’s approval may constitute a misdemeanor, subject to fine or 

imprisonment for up to one year or both. Id.; see also 18 U.S.C. § 292. Demands for payment of fees to a 

representative, prior to approval by the Board, may be reported to appropriate authorities for investigation.

2

5 U.S.C. § 8101 et seq.
2

ISSUE

The issue is whether appellant has met his burden of proof to establish a diagnosed medical 

condition causally related to the accepted August 10, 2019 employment incident.

FACTUAL HISTORY

On August 12, 2019 appellant, then a 31-year-old firefighter technician, filed a traumatic 

injury claim (Form CA-1) alleging that on August 10, 2019 he experienced sharp, unbearable chest 

pain, which radiated into his left arm and back, followed by dizziness, after he had hiked to his 

assigned location and began working with a smoldering piece of duff while in the performance of 

duty. He stopped work on August 10, 2019.

OWCP received an unsigned hospital report, noting that appellant was hospitalized from 

August 10 to 11, 2019. An August 10, 2019 electrocardiogram (ECG) revealed sinus bradycardia, 

sinus arrhythmia, and early repolarization, but otherwise demonstrated normal results. In an

Emergency Medical Service (EMS) note of even date, Sarah Pehrson, an EMS technician

conducted a physical examination and diagnosed chest pain.

Dr. Daniel Honneyman, an emergency medicine specialist, diagnosed smoke inhalation 

and chest pain in treatment reports dated August 10, 2019. He provided differential diagnoses of 

smoke inhalation and bronchoconstriction versus acute coronary syndrome (ACS) versus 

pulmonary embolism (PE) versus reflux.

An August 10, 2019 x-ray of the chest revealed no plain radiographic evidence of active 

cardiopulmonary disease.

In an August 10, 2019 unsigned work status note, an unidentifiable healthcare provider 

provided work restrictions.

In an August 11, 2019 emergency department report, Brendon A. Coulson, a registered 

nurse, noted that appellant presented with worsening chest pain. 

An ECG of even date revealed sinus bradycardia and early repolarization, but demonstrated 

otherwise normal results.

In an August 11, 2019 discharge report, Dr. Honneyman diagnosed chest pain and 

exposure to smoke/flames. In an unsigned report of even date, an unidentifiable healthcare 

provider diagnosed chest pain and exposure to smoke.

Diagnostic tests of the abdomen, pelvis and chest conducted on August 11, 2019 revealed 

no acute findings or active cardiopulmonary disease. An August 11, 2019 after-visit summary

noted that appellant was seen by Dr. Ryan Ernst, an emergency medicine specialist, and diagnosed 

with chest pain of uncertain etiology.

In unsigned August 14, 2019 reports, an unidentifiable healthcare provider diagnosed chest 

pain.
3

In a September 3, 2019 medical report, Dr. Ernst R. von Schwarz, Board-certified in 

cardiovascular disease and advanced heart failure and transplant cardiology, conducted a physical 

examination, reviewed appellant’s echocardiogram (echo) and treadmill stress test results, and 

diagnosed chest pain with bradycardia. He indicated that appellant had abnormal 

electrocardiographic findings. In a September 3, 2019 duty status report (Form CA-17), an 

unidentifiable healthcare provider diagnosed chest pain.

In an October 10, 2019 development letter, OWCP informed appellant of the deficiencies 

of his claim. It advised him of the type of factual and medical evidence needed and afforded 

appellant 30 days to respond.

An undated cardiac ultrasound report revealed no pericardial effusion or pulmonary edema.

In an August 10, 2019 work status report, Dr. Honneyman indicated that appellant could 

return to work without restrictions on August 12, 2019.

On August 10, 2019 the employing establishment executed an authorization for 

examination and/or treatment (Form CA-16). In an undated Part B of the Form CA-16, attending 

physician’s report, Dr. Honneyman diagnosed smoke inhalation and chest pain.

Dr. Ernst, in August 11, 2019 medical reports, noted that appellant had a history of peptic 

ulcer disease and hiatal hernia and presented with chest pain. He diagnosed chest pain of uncertain 

etiology. 

An August 12, 2019 ECG revealed sinus bradycardia and early repolarization, but 

demonstrated otherwise normal results.

In an August 20, 2019 medical report, Dr. von Schwarz diagnosed chest pain with

bradycardia. He noted that appellant had abnormal electrocardiographic findings.

An August 22, 2019 echocardiogram revealed palpitations, chest pain, and abnormal 

electrocardiographic findings.

In an August 26, 2019 report, Brenda Robinson, a physician assistant, indicated that 

appellant underwent a treadmill stress test.

In an October 24, 2019 statement, appellant reiterated that he experienced chest pain at 

work on August 10, 2019 after being exposed to a small piece of smoldering duff. He noted that 

he was diagnosed with chest pain caused by smoke inhalation and contended that pain should be

considered as a diagnosis.

In a November 6, 2019 attending physician’s report (Form CA-20), Dr. von Schwarz 

diagnosed chest pain and checked a box marked “Yes” indicating that his condition was caused or 

aggravated by the described employment activity.

By decision dated November 21, 2019, OWCP accepted that the August 10, 2019 

employment incident occurred as alleged, but denied the claim, finding that the medical evidence 

of record did not contain a medical diagnosis in connection with the accepted employment 
4

incident. Consequently, it found that the requirements had not been met to establish an injury as 

defined by FECA.

In a November 25, 2019 Form CA-20,Dr. Honneyman noted the accepted August 10, 2019 

employment incident and indicated that appellant sustained chest pain from smoke exposure. He 

checked a box marked “Yes” indicating that his condition was caused or aggravated by the 

described employment activity.

In a December 1, 2019 statement, appellant contended that OWCP’s decision was based 

on false premises and misrepresented facts.

On December 3, 2019 appellant requested a review of the written record by a representative 

of OWCP’s Branch of Hearings and Review.

By decision dated February 4, 2020, OWCP’s hearing representative affirmed the 

November 21, 2019 decision.

On January 11, 2021 appellant, through counsel, requested reconsideration. 

On August 31, 2020 Dr. Neil Allen, Board-certified in internal medicine, performed a 

records review and noted that appellant began experiencing tightness and pain in his chest after 

hiking approximately one mile to his worksite with 65 pounds of gear in smoky conditions. He 

reviewed his medical records and diagnosed stable angina pectoris. Dr. Allen indicated that 

appellant was asymptomatic prior to the accepted August 10, 2019 employment incident. He 

explained that stable angina mostly occurred when the body was placed in a stressful situation, 

which would require more oxygen. Dr. Allen further explained that appellant was subject to 

physical stress while extinguishing hot spots in an environment with limited oxygen. He opined 

that the accepted August 10, 2019 employment incident directly caused his diagnosed angina.

By decision dated February 12, 2021, OWCP denied modification of its February 4, 2020 

decision.

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).
5

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 

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

condition and an employment incident is rationalized medical opinion evidence. 8 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.9

ANALYSIS

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

In his August 10, 2019 treatment reports, Dr. Honneyman diagnosed smoke inhalation. 

Thereafter, in a November 25, 2019 Form CA-20, he noted smoke exposure, which he indicated 

was caused or aggravated by the described August 10, 2019 employment activity. 

In addition, Dr. von Schwarz, in his September 3, 2019 medical report, noted that he 

conducted a physical examination and reviewed appellant’s echo and treadmill stress test results. 

He diagnosed bradycardia. 

Therefore, the Board finds that the evidence of record establishes diagnosed medical 

conditions of smoke inhalation and bradycardia.

As the medical evidence of record establishes diagnosed medical conditions, the case must 

be remanded for consideration of the medical evidence with regard to the issue of causal 

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

S.S., Docket No. 19-0688 (issued January 24, 2020); A.M., Docket No. 18-1748 (issued April24, 2019); RobertG. 

Morris, 48 ECAB 238 (1996).

9 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).
6

relationship.10 Following this and other such further development as deemed necessary, OWCP 

shall issue a de novo decision.

11

CONCLUSION

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

condition. The Board further finds, however, that the case is not in posture for decision as to 

whether his diagnosed conditions are causally related to the accepted August 10, 2019 employment 

incident.

ORDER

IT IS HEREBY ORDERED THAT the February 12, 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: July 6, 2022

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

10 S.A., Docket No. 20-1498 (issued March 11, 2021).

11 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. See20 C.F.R. § 10.300(c); J.G., Docket No. 17-

1062 (issued February 13, 2018); Tracy P. Spillane, 54 ECAB 608 (2003).