United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

R.F., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE,

Cocoa Beach, FL, Employer

__________________________________________

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Docket No. 20-1181

Issued: February 11, 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

CHRISTOPHER J. GODFREY, Deputy Chief Judge

PATRICIA H. FITZGERALD, Alternate Judge

JURISDICTION

On May 12, 2020 appellant filed a timely appeal from December 3, 2019 and April 3, 2020 

merit decisions and an April 24, 2020 nonmerit 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

ISSUES

The issues are: (1) whether appellant has met his burden of proof to establish a medical 

condition causally related to the accepted October 14, 2019 employment incident; and (2) whether 

 

1 5 U.S.C. § 8101 et seq.

2 The Board notes that, following the April 24, 2020 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

OWCP properly denied appellant’s request for reconsideration of the merits of his claim pursuant 

to 5 U.S.C. § 8128(a).

FACTUAL HISTORY

On October 24, 2019 appellant, then a 34-year-old city carrier assistant, filed a traumatic 

injury claim (Form CA-1) alleging that on October 14, 2019 he suffered brief unconsciousness, a 

laceration to the right eyebrow, concussion, and loss of memory after tripping over a curb when 

walking inside to clock in for work while in the performance of duty. On the reverse side of the 

claim form the employing establishment controverted appellant’s claim, contending that he was 

not injured in the performance of duty as he was injured prior to starting his shift. It further asserted 

that the injury was caused by appellant’s possible intoxication. Appellant did not stop work.

In a development letter dated October 30, 2019, OWCP informed appellant that the 

evidence of record was insufficient to establish his claim. It advised him of the type of factual and 

medical evidence needed and provided a questionnaire for his completion. OWCP noted that 

documentation had not been received to establish that appellant actually experienced the incident 

alleged to have caused injury. It also indicated that medical evidence had not been received, which 

supported a medical diagnosis in connection with the alleged employment incident. In a separate 

development letter of even date, OWCP requested that the employing establishment provide 

additional information, including evidence regarding appellant’s possible intoxication and his tour 

of duty. It afforded both parties 30 days to respond. 

OWCP subsequently received a request for authorization for a magnetic resonance imaging 

(MRI) scan of appellant’s brain from Dr. Gary Weiss, a Board-certified anatomic and clinical 

pathologist.

By decision dated December 3, 2019, OWCP accepted that the incident occurred as 

alleged, but denied appellant’s claim, finding that the medical evidence of record was insufficient 

to establish a medical diagnosis in connection with the accepted October 14, 2019 employment 

incident. It concluded, therefore, that the requirements had not been met to establish an injury as 

defined by FECA. 

On December 31, 2019 OWCP received appellant’s November 3, 2019 response to the 

development questionnaire. Appellant noted that he was not impaired in any way when the injury 

occurred. He indicated that he tripped on the sidewalk outside of the employing establishment

before he began his tour of duty. Appellant reported that he fell on his right knee and shoulder 

and that he struck his head on the brick wall of the building. He noted that his right eye was cut 

open above his eyebrow and that he briefly lost consciousness. Appellant indicated that his 

coworker notified the postmaster of the incident. He stated that he stopped work for two days and 

that he delayed filing his Form CA-1 because the postmaster informed him that he might not be 

eligible to file a claim. Appellant noted that he experienced brief unconsciousness, confusion, 

pain, and loss of balance immediately after the employment incident and that he went inside the 

employing establishment to wash the blood from his face after the incident. He indicated that he 

did not have any similar disability or symptoms prior to the employment incident. 
3

In an October 14, 2019 state workers’ compensation form report, Dr. Pierce Arnold, a 

Board-certified family practitioner, diagnosed laceration of the right eyebrow and mild concussion. 

He checked a box to indicate that the conditions for which treatment was sought were work related. 

In an October 24, 2019 form report, Dr. Arnold diagnosed laceration of the right eyebrow. 

He indicated that appellant had his sutures removed and that he had reached maximum medical 

improvement.

On January 31, 2020 appellant requested reconsideration. He asserted that he had 

previously submitted medical evidence by fax and mail. 

By decision dated April 3, 2020, OWCP modified the December 3, 2019 decision, finding 

that appellant had established valid medical diagnoses. However, the claim remained denied 

because the medical evidence of record was insufficient to establish a causal relationship between 

the diagnosed medical conditions and the accepted October 14, 2019 employment incident.

On April 16, 2020 appellant requested reconsideration. In support of his request, he

submitted an October 24, 2019 narrative report from Dr. Arnold who examined appellant and 

diagnosed laceration of the right eyebrow. Dr. Arnold noted that the encounter was related to 

appellant’s workers’ compensation claim and that his sutures were removed without 

complication.3 

By decision dated April 24, 2020, OWCP denied appellant’s request for reconsideration of 

the merits of his claim pursuant to 5 U.S.C. § 8128(a). 

LEGAL PRECEDENT -- ISSUE 1

An employee seeking benefits under FECA4 has the burden of proof to establish the 

essential elements of his or her claim, including the fact 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 period of FECA,5that 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.6 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.7

 

3 Appellant also resubmitted form reports from Dr. Arnold dated October 14 and 24, 2019.

4 Supra note 1.

5 M.O., Docket No. 19-1398 (issued August 13, 2020); S.B., Docket No. 17-1779 (issued February 7, 2018); Joe D. 

Cameron, 41 ECAB 153 (1989).

6

J.R., Docket No. 20-0496 (issued August 13, 2020); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40 ECAB 

312 (1988).

7 B.M., Docket No. 19-1341 (issued August 12, 2020); L.M., Docket No. 13-1402 (issued February 7, 2014); 

Delores C. Ellyett, 41 ECAB 992 (1990).
4

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

OWCP begins with an analysis of whether fact of injury has been established. 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.8 The second component is whether the employment incident caused a personal injury.9

Causal relationship is a medical question that requires rationalized medical opinion 

evidence to resolve the issue.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 incident identified by the claimant.11

OWCP’s procedures recognize that a claim may be accepted without a medical report when 

the condition is a minor one which can be identified on visual inspection.12 In clear-cut traumatic 

injury claims, such as a fall resulting in a broken arm, a physician’s affirmative statement is 

sufficient and no rationalized opinion on causal relationship is needed. In all other traumatic injury 

claims, a rationalized medical opinion supporting causal relationship is required.13

ANALYSIS -- ISSUE 1

The Board finds that appellant has met his burden of proof to establish a laceration causally 

related to the accepted October 14, 2019 employment incident.

In support of his claim, appellant submitted reports dated October 14 and 24, 2019 from

Dr. Arnold. Dr. Arnold diagnosed laceration of the right eyebrow and opined that the condition

was work related. OWCP accepted that the October 14, 2019 employment incident occurred as 

alleged, that a medical condition had been diagnosed, and that appellant was injured in the 

performance of duty. As noted above, OWCP’s procedures recognize that a claim may be accepted 

without a medical report when the condition is a minor one which can be identified on visual 

inspection.14 The Board, thus, finds that this evidence is sufficient to meet appellant’s burden of 

proof that he sustained a right eyebrow laceration on October 14, 2019.15 Upon return of the case 

 

8 T.J., Docket No. 19-0461 (issued August 11, 2020); Elaine Pendleton, 40 ECAB 1143 (1989).

9 D.M., Docket No. 20-0386 (issued August 10, 2020); John J. Carlone, 41 ECAB 354 (1989).

10 A.R., Docket No. 19-0465 (issued August 10, 2020); Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000).

11 W.L., Docket No. 19-1581 (issued August 5, 2020); Leslie C. Moore, 52 ECAB 132 (2000).

12 See Federal (FECA) Procedure Manual, Part 2 -- Claims, Initial Development of Claims, Chapter 2.800.6(a) 

(June 2011); Chapter 2.805.3(c) (January 2013). See also M.F., Docket No. 19-0578 (issued January 26, 2021); S.S., 

Docket No. 20-0509 (issued August 18, 2020).

13 Id. at Chapter 2.805.3(d) (January 2013).

14 Supra note 12; see also K.P., Docket No. 18-0350 (issued February 11, 2020); A.P., Docket No. 19-0224 (issued 

July 11, 2019).

15 Id.
5

record OWCP shall make payment and/or reimbursement of medical expenses with regard to the 

accepted laceration of the right eyebrow.16 

The Board further finds, however, that appellant has not established additional conditions 

as causally related to the accepted employment injury. 

In his October 14 and 24, 2019 form reports, Dr. Arnold also diagnosed a mild concussion. 

In an October 14, 2019 state workers’ compensation form report, he checked a box to indicate that 

the conditions for which treatment was sought were work related. However, the Board has held 

that an opinion on causal relationship with an affirmative check mark, without more, by way of 

medical rationale, is insufficient to establish the claim.17 In October 24, 2019 report, Dr. Arnold 

noted that he examined appellant and diagnosed laceration of the right eyebrow. He opined that 

the encounter was related to appellant’s workers’ compensation claim. However, Dr. Arnold did 

not offer medical rationale to explain how or why the accepted employment injury caused or 

contributed to appellant’s diagnosed concussion. The Board has held that a report is of limited 

probative value regarding causal relationship if it does not contain medical rationale explaining 

how a given medical condition/disability was related to employment factors.18 As such,

Dr. Arnold’s reports are insufficient to establish additional conditions as causally related to the 

accepted employment injury. 

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.

LEGAL PRECEDENT -- ISSUE 2

Section 8128 (a) of FECA19 vests OWCP with discretionary authority to determine whether 

to review an award for or against compensation. The Secretary of Labor may review an award for 

or against payment of compensation at any time on his own motion or on application.20

To require OWCP to reopen a case for merit review under 5 U.S.C. § 8128(a), OWCP 

regulations provide that the evidence or argument submitted by a claimant must: (1) show that 

OWCP erroneously applied or interpreted a specific point of law; (2) advance a relevant legal 

 

16 See B.C., Docket No. 20-0498 (issued August 27, 2020) (the Board accepted lumbar contusion as causally related 

to the accepted employment incident); S.H., Docket No. 20-0113 (issued June 24, 2020) (the Board accepted a right 

ankle contusion as causally related to the accepted employment incident); M.A., Docket No. 13-1630 (issued 

June 18, 2014).

17 C.S., Docket No. 18-1633 (issued December 30, 2019); D.S., Docket No. 17-1566 (issued December 31, 2018).

18 See Y.D., Docket No. 16-1896 (issued February 10, 2017) (a report is of limited probative value regarding causal 

relationship if it does not contain medical rationale describing the relationship between work factors and a diagnosed 

condition/disability).

19 Supra note 1

20 5 U.S.C. § 8128(a).
6

argument not previously considered by OWCP; or (3) constitute relevant and pertinent new 

evidence not previously considered by OWCP.21

A request for reconsideration must be received by OWCP within one year of the date of its 

decision for which review is sought.22 If it chooses to grant reconsideration, it reopens and reviews 

the case on its merits.23 If the request is timely, but fails to meet at least one of the requirements 

for reconsideration, OWCP will deny the request for reconsideration without reopening the case 

for review on the merits.24

ANALYSIS -- ISSUE 2

The Board finds that OWCP properly denied appellant’s request for reconsideration with 

regard to his claim that he sustained a concussion causally related to the accepted employment 

injury. 

Appellant’s April 16, 2020 request for reconsideration did not establish that OWCP 

erroneously applied or interpreted a specific point of law, or advance a relevant legal argument not 

previously considered by OWCP. Consequently, the Board finds that he is not entitled to a review 

of the merits based on either the first or second requirement under 20 C.F.R. § 10.606(b)(3).25

In support of his request, appellant submitted an October 24, 2019 report from Dr. Arnold 

who examined him and diagnosed laceration of the right eyebrow. Dr. Arnold noted that the 

encounter was related to appellant’s workers’ compensation claim and that his sutures were 

removed without complication. Appellant also resubmitted form reports from Dr. Arnold, dated 

October 14 and 24, 2019. Providing additional medical evidence that either duplicates or is 

substantially similar to evidence of record does not constitute a basis for reopening a case.26 As 

appellant did not provide relevant and pertinent new evidence, he is not entitled to a merit based 

on the third requirement under 20 C.F.R. § 10.606(b)(3).27

 

21 20 C.F.R. § 10.606(b)(3); see also H.H., Docket No. 18-1660 (issued March 14, 2019); L.G., Docket No. 09-1517 

(issued March 3, 2010); C.N., Docket No. 08-1569 (issued December 9, 2008)

22 Id. at § 10.607(a). For merit decisions issued on or after August 29, 2011, a request for reconsideration must be 

received by OWCP within one year of its decision for which review is sought. Federal (FECA) Procedure Manual, 

Part 2 -- Claims, Reconsiderations, Chapter 2.1602.4 (February 2016). Timeliness is determined by the document 

receipt date of the request for reconsideration as indicated by the received date in the Integrated Federal Employees’

Compensation System (iFECS). Id. at Chapter 2.1602.4b

23 Id. at § 10.608(a); see also M.S., 59 ECAB 231 (2007).

24 Id. at § 10.608(b); E.R., Docket No. 09-1655 (issued March 18, 2010).

25 Supra note 23.

26 M.O., Docket No. 19-1677 (issued February 25, 2020); Eugene F. Butler, 36 ECAB 393, 398 (1984).

27 S.H., Docket No. 19-1897 (issued April 21, 2020); M.K., Docket No. 18-1623 (issued April 10, 2019); 

Edward Matthew Diekemper, 31 ECAB 224-25 (1979).
7

CONCLUSION

The Board finds that appellant has met his burden of proof to establish a laceration causally 

related to the accepted October 14, 2019 employment incident. The Board further finds, however, 

that appellant has not established that his diagnosed concussion was causally related to the 

accepted employment injury and OWCP properly denied appellant’s request for reconsideration 

of the merits of his claim with regard to the diagnosed concussion. 

ORDER

IT IS HEREBY ORDERED THAT the December 3, 2019 and April 3 and 24, 2020 

decisions of the Office of Workers’ Compensation Programs are affirmed in part and reversed in 

part and the case is remanded for further proceedings consistent with this decision of the Board.28

Issued: February 11, 2021

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board

 

28 Christopher J. Godfrey, Deputy Chief Judge, who participated in the preparation of the decision, was no longer 

a member of the Board after January 20, 2021.