United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

L.H., Appellant

and

DEPARTMENT OF VETERANS AFFAIRS, 

CLEMENT J. ZABLOCKI VA MEDICAL 

CENTER, Milwaukee, WI, Employer

__________________________________________

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Docket No. 21-1398

Issued: April 11, 2022

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

JANICE B. ASKIN, Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On September 23, 2021 appellant filed a timely appeal from a June 3, 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 her burden of proof to establish a medical condition 

causally related to the accepted April 8, 2021 employment incident.

FACTUAL HISTORY

On April 19, 2021 appellant, then a 44-year-old nursing assistant, filed a traumatic injury 

claim (Form CA-1) alleging that on April 8, 2021 she broke her right ring and little fingers while 

in the performance of duty. She indicated that she slipped and fell and tried to grab a door with 

her right hand, and the door “slammed on her hand.” On the reverse side of the claim form, B.G., 

an assistant nurse manager, acknowledged that appellant was in the performance of duty when the 

incident occurred and that her knowledge of the facts about the injury was in agreement with 

appellant’s statements. Appellant stopped work on April 9, 2021. 

Dr. Anna Tyszkowska, a Board-certified internist, noted in an April 8, 2021 emergency 

room medical report, that appellant was seen for severe pain in the right fourth and fifth digits, 

which she attributed to slamming her fingers in a door at work. On physical examination, she 

noted that appellantwas unable to bend her fingers due to pain and observed a superficial laceration 

at the palmar aspect of the fifth digit of her right hand. Thereafter Dr. Thomas Rudek, a Boardcertified emergency medicine specialist, in a report of even date, indicated that he reviewed the 

x-rays of appellant’s right hand and performed a physical examination, noting a small wound at 

the proximal fifth phalanx. He applied a splint to the right fifth digit.

A report of x-rays of the right hand, dated April 8, 2021, revealed a faint lucency/area of 

mild contour irregularity at the proximal aspect of the distal phalanx of the fifth digit, which was 

possibly consistent with a subtle nondisplaced acute fracture, and a contour deformity of the fifth 

metacarpal, which was likely chronic. 

In an employing establishment report of emergency treatment also dated April 8, 2021, an 

unknown medical provider released appellant to return to work with no use of the right hand,

effective April 9, 2021.

In an April 29, 2021 development letter, OWCP advised appellant of the deficiencies of 

her claim and requested that she provide a narrative medical report from a treating physician, 

containing a medical diagnosis and explaining how the employment incident caused, contributed 

to, or aggravated her diagnosed medical condition. It afforded her 30 days to respond.

In an April 30, 2021 letter, Meghan A. Furlow, a physician assistant, released appellant to 

return to full-time, left hand only work as of May 3, 2021.

In a May 12, 2021 letter of controversion on behalf of the employing establishment, an 

employing establishment registered nurse and workers’ compensation specialist, reviewed 

appellant’s history of injury and recommended denial of her claim due to inconsistencies, a lack 

of a medical diagnosis, and the x-ray finding of a likely chronic contour deformity of the fifth 

metacarpal.

By decision dated June 3, 2021, OWCP accepted that the April 8, 2021 employment 

incident occurred as alleged. However, it denied the claim, finding that the medical evidence of 
3

record was insufficient to establish a medical condition causally related to the accepted 

employment incident. Consequently, OWCP found that appellant had not met the requirements to 

establish an injury as defined by FECA. 

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 

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. The first component is that 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 incident 

identified by the employee.9

3

Supra note 1.

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 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 P.C., Docket No. 20-0855 (issued November 23, 2020); Y.S., Docket No. 18-0366 (issued January 22, 2020); 

Victor J. Woodhams, 41 ECAB 345, 352 (1989).
4

ANALYSIS

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

laceration at the palmar aspect of the fifth digit of the right hand causally related to the accepted 

April 8, 2021 employment incident.

OWCP found that the April 8, 2021 employment incident had occurred in the performance 

of duty, as alleged. In the April 8, 2021 emergency room notes, Drs. Tyszkowska and Rudek both 

observed a superficial laceration at the palmar aspect of the fifth digit of the right hand. As the 

evidence of record establishes that appellant’s employment incident resulted in a visible injury, 

the Board therefore finds that appellant has met her burden of proof to establish a superficial 

laceration at the palmar aspect of the fifth digit of the right hand.

10

 The case shall be remanded 

for payment of medical expenses and wage-loss compensation for any attendant disability.

The Board further finds, however, that appellant has not met her burden of proof to 

establish any additional medical conditions in connection with the accepted April 8, 2021

employment injury.

The employing establishment report of emergency treatment of even date and the April 30, 

2021 letter by Ms. Furlow did not contain a diagnosis. The Board has held that a medical report 

lacking a firm diagnosis is of no probative value.11 Therefore, this evidence is insufficient to 

establish appellant’s claim.

Appellant submitted a report of x-rays of the right hand, dated April 8, 2021, which noted 

a “possible” acute fracture of the distal phalanx of the fifth digit and a “likely chronic” contour 

deformity of the fifth metacarpal. The Board has also held that diagnostic reports, standing alone, 

lack probative value on the issue of causal relationship as they do not provide an opinion as to 

whether the accepted employment incident caused a diagnosed condition. 12 Consequently, this 

evidence is insufficient to establish appellant’s claim.

The Board therefore finds that appellant has submitted insufficient medical evidence to 

establish an additional medical condition causally related to the accepted April 8, 2021

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.

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

(June 2011); Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.805.3(c) 

(January2013). See also P.B., Docket No. 20-1643 (issued March 30, 2022); R.H., Docket No. 20-1684 (issued 

August 27, 2021); A.J., Docket No. 20-0484 (issued September 2, 2020); S.K., Docket No. 18-1411 (issued 

July 22, 2020).

11 J.P., Docket No. 20-0381 (issued July 28, 2020); R.L., Docket No. 20-0284 (issued June 30, 2020).

12 W.L., Docket No. 20-1589 (issued August26, 2021); A.P., Docket No. 18-1690 (issued December 12, 2019).
5

CONCLUSION

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

laceration at the palmar aspect of the fifth digit of the right hand causally related to the accepted 

April 8, 2021 employment incident. The Board further finds, however, that she has not met her 

burden of proof to establish an additional medical condition in connection with the accepted 

April 8, 2021 employment injury.

ORDER

IT IS HEREBY ORDERED THAT the June 3, 2021 decision of the Office of Workers’

Compensation Programs is reversed in part and affirmed in part. The case is remanded for further 

proceedings consistent with this decision of the Board.

Issued: April 11, 2022

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board