United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

W.B., Appellant

and

DEPARTMENT OF HOMELAND SECURITY, 

TRANSPORTATION SECURITY 

ADMINISTRATION, Moline, IL, Employer

__________________________________________

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Docket No. 22-0163

Issued: September 16, 2022

Appearances: Case Submitted on the Record

Appellant, pro se 

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

PATRICIA H. FITZGERALD, Deputy Chief Judge

JANICE B. ASKIN, Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On November 15, 2021 appellant filed a timely appeal from an October 15, 2021 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 her burden of proof to establish a diagnosed medical

condition causally related to the accepted August 26, 2021 employment incident.

FACTUAL HISTORY

On August 27, 2021 appellant, then a 67-year-old transportation industry analyst, filed a 

traumatic injury claim (Form CA-1) alleging that on August 26, 2021 she cracked her ribs, 

1

5 U.S.C. § 8101 et seq.
2

dislocated her right shoulder, and sustained a rotator cuff tear as a result of falling while in the 

performance of duty. She stopped work on the date of injury.

In a report dated August 26, 2021, David Kieser, a certified nurse practitioner, noted that 

appellant complained of right shoulder and lateral rib pain, which she attributed to falling at work

that day. He further indicated that x-rays of herright shoulder and chestrevealed a shoulder sprain.

Mr. Keiser ordered magnetic resonance imaging (MRI) scans of appellant’s right shoulder and 

recommended that she remain out of work until September 10, 2021.

In an August 30, 2021 report of MRIscan, Dr. David Griffith, a Board-certified radiologist, 

noted a history that appellant fell at her workplace on August 26, 2021. He indicated that the study

revealed cuff tendinosis, moderate acromioclavicular (AC) joint arthrosis, a small effusion and 

capsulitis, and labral fraying with a nondisplaced anterior-inferior labral tear.

On September 10, 2021 Dr. Edward Kolb, a Board-certified orthopedic surgeon, noted that 

appellant related ongoing complaints of right shoulder and rib pain. He performed a physical 

examination, which revealed pain with palpation of the lateral aspect of the right ribs and positive 

impingement, Speed’s, and Yergason’s signs in the right shoulder. Dr. Kolb reviewed the MRI 

scan results and diagnosed a dislocation of the right shoulder, right rib fractures, and a sprain of 

the shoulder girdle.

By development letter dated September 14, 2021, OWCP informed appellant of the 

deficiencies of her claim. It advised her of the type of factual and medical evidence required and 

provided a questionnaire for her completion. OWCP afforded appellant 30 days to submit the 

necessary evidence.

On September 14, 2021 appellant accepted a temporary limited-duty assignment including 

intermittent sitting, walking, and standing.

In a medical report dated September 24, 2021, Dr. Kolb noted that appellant related 

ongoing shoulder pain, which she attributed to an injury four weeks prior. He further noted that 

she indicated her symptoms had improved with modified work duties and medical treatment.

Dr. Kolb performed a physical examination and diagnosed closed fracture of multiple ribs, 

dislocation of the right shoulder, and a sprain of the right shoulder girdle. He recommended 

restrictions of sitting down as needed, no overhead work, and no lifting over 10 pounds.

By decision dated October 15, 2021, OWCP accepted that the August 26, 2021

employment incident occurred in the performance of duty, as alleged. However, it denied 

appellant’s claim, finding that the medical evidence of record was insufficient to establish a 

diagnosed medical condition in connection with the accepted employment incident.

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 

2

Id.
3

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. The first component is whether, the 

employee 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.6

The medical evidence required to establish 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 incident

identified by the employee.8

ANALYSIS

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

condition causally related to the accepted August 26, 2021 employment incident.

Dr. Kolb, in his September 10 and 24, 2021 reports, diagnosed closed fracture of multiple 

ribs, dislocation of the right shoulder, and a sprain of the right shoulder girdle . The Board, 

therefore, finds that the record establishes diagnosed medical conditions in connection with the 

established employment incident.

9

The Board further finds, however, that this case is not in posture for decision with regard 

to whether the diagnosed medical conditions are causally related to the accepted August 26, 2021

3 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). 

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); 

DeloresC.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 April24, 2019); RobertG. 

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).

9

See S.A., Docket No. 20-1498 (issued March 11, 2021); A.H., Docket No. 20-0730 (issued October 27, 2020); 

B.C., Docket No. 20-0079 (issued October 16, 2020).
4

employment incident. 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 relationship.10 Following this and other such further development as deemed 

necessary, OWCP shall issue a de novo decision.

CONCLUSION

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

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

whether her diagnosed conditions are causally related to the accepted August 26, 2021

employment incident. 

ORDER

IT IS HEREBY ORDERED THAT the October 15, 2021 decision of the Office of 

Workers’ Compensation Programs is set aside, and the case is remanded for further proceedings 

consistent with this order of the Board.

Issued: September 16, 2022

Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board

10 See F.D., Docket No. 21-1045 (issued December 22, 2021).