United States Department of Labor

Employees’ Compensation Appeals Board

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S.C., Appellant

and

DEPARTMENT OF THE AIR FORCE, AIR 

FORCE RESERVE OFFICER TRAINING 

CORPS, Terre Haute, IN, Employer

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Docket No. 22-0294

Issued: October 24, 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 December 10, 2021 appellant filed a timely appeal from a June 17, 2021 merit decision 

and an October 27, 2021 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 an injury in 

the performance of duty on May 5, 2021, as alleged; and (2) whether OWCP properly denied his 

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

1

5 U.S.C. § 8101 et seq.

2 The Board notes that, following the October 27, 2021 decision, appellant submitted additional evidenceto OWCP. 

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

FACTUAL HISTORY

On May 6, 2021 appellant, then a 21-year-old Reserve Officers’ Training Corps (ROTC) 

cadet, filed a traumatic injury claim (Form CA-1) alleging that on May 5, 2021 he developed 

weakness and collapsed on the floor due to a high heart rate of more than 160 beats per minute 

(BPM) after running 1.5 miles for the ROTC qualification fitness requirement while in the 

performance of duty. On the reverse side of the claim form, the employing establishment 

acknowledged that he was injured in the performance of duty.

In a May 6, 2021 memorandum, appellant’s supervisor, D.S., recounted that he had 

collapsed after completing his 1.5 mile run during his qualification fitness requirement test and 

required immediate medical care. He was transported to the emergency room by ambulance and 

treated at the hospital that same day. Appellant was discharged on May 6, 2021.

In a May 17, 2021 development letter, OWCP informed appellant of the deficiencies of his 

claim. It advised him of the type of factual and medical evidence necessary and afforded him 30

days to respond. 

On May 6, 2021 the employing establishment executed an authorization for examination 

and/or treatment (Form CA-16) asserting that appellant collapsed due to extreme exhaustion on 

May 5, 2021. Dr. Daniel Stahl, an osteopath specializing in family medicine, completed the Form 

CA-16 on May 14, 2021 and diagnosed dehydration, acute kidney injury, and metabolic and 

kidney leukocytosis. He checked a box marked “Yes” indicating that the diagnosed conditions 

were caused or aggravated by appellant’s May 5, 2021 employment injury. 

By decision dated June 17, 2021, OWCP denied appellant’s traumatic injury claim,finding

that he had not established the factual component of his claim, as he had not provided evidence or 

a statement explaining how he was injured as a result of the alleged employment incident. It noted 

that he had not responded to the request for a factual statement in the May 17, 2021 development 

letter. OWCP concluded, therefore that the requirements had not been met to establish an injury 

as defined by FECA.

On September 21, 2021 appellant requested reconsideration and submitted a statement 

alleging that he was injured on May 5, 2021 during his required physical fitness assessment. He 

asserted that he collapsed as he was finishing his 1.5 mile run and was taken to the hospital. 

Appellant listed his diagnoses as metabolic acidosis, sinus tachycardia, acute kidney injury, 

dyspnea, and leukocytosis. He provided his discharge instructions.

By decision dated October 27, 2021, OWCP denied appellant’s request for reconsideration 

of the merits of his claim.

LEGAL PRECEDENT -- ISSUE 1

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 

3

Supra note 1.
3

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 must first be determined whether fact of injury has been established.7 

Generally, fact of injury consists of two components that must be considered in conjunction with 

one another. 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.8 Second, 

the employee must submit sufficient evidence to establish that the employment incident caused a 

personal injury.9

To establish that an injury occurred as alleged, the injury need not be confirmed by 

eyewitnesses, but the employee’s statements must be consistent with the surrounding facts and 

circumstances and his or her subsequent course of action. The employee has not met his or her 

burden when there are such inconsistencies in the evidence as to cast serious doubt on the validity 

of the claim. Such circumstances as late notification of injury, lack of confirmation of injury, 

continuing to work without apparent difficulty following the alleged injury, and failure to obtain 

medical treatment may, if otherwise unexplained, cast serious doubt on the employee’s statements 

in determining whether a prima facie case has been established.10 An employee’s statement 

alleging that an injury occurred at a given time and in a given manner is of great probative v alue 

and will stand unless refuted by strong or persuasive evidence.11

ANALYSIS -- ISSUE 1

The Board finds that appellant has met his burden of proof to establish that the May 5, 2021 

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

As noted, an employee’s statement alleging that an injury occurred at a given time and 

place, and in a given manner, is of great probative value and will stand unless refuted by strong or 

4

J.P., Docket No. 19-0129 (issued April26, 2019); S.B., Docket No. 17-1779 (issued February 7, 2018); JoeD. 

Cameron, 41 ECAB 153 (1989).

5

J.M., Docket No. 17-0284 (issued February 7, 2018); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40 

ECAB 312 (1988).

6 R.R., Docket No. 19-0048 (issued April 25, 2019); L.M., Docket No. 13-1402 (issued February 7, 2014); 

DeloresC. Ellyett, 41 ECAB 992 (1990).

7 E.M., Docket No. 18-1599 (issued March 7, 2019); T.H., 59 ECAB 388, 393-94 (2008).

8 L.T., Docket No. 18-1603 (issued February 21, 2019); Elaine Pendleton, 40 ECAB 1143 (1989).

9 B.M., Docket No. 17-0796 (issued July 5, 2018); JohnJ. Carlone, 41 ECAB 354 (1989).

10 M.F., Docket No. 18-1162 (issued April9, 2019); Charles B. Ward, 38 ECAB 667, 67-71 (1987).

11 B.M., Docket No. 21-1185 (issued March 4, 2022); L.D., Docket No. 16-0199 (issued March 8, 2016); Betty J. 

Smith, 54 ECAB 174 (2002).
4

persuasive evidence.12 Appellant alleged that he experienced weakness and collapsed on the floor 

due to a high heart rate of more than 160 BPM after running 1.5 miles for the ROTC qualification 

fitness requirement. He provided a detailed account of the incident on his May 6, 2021 claim form. 

The employing establishment acknowledged that he was injured in the performance of duty. D.S., 

his supervisor, provided a May 6, 2021 statement, and recounted that appellant had collapsed after 

completing his 1.5 mile run during his qualification fitness requirement test, and required 

immediate medical care.

Additionally, appellant provided a consistent description of the May 5, 2021 employment 

incident to his physician. On May 14, 2021 Dr. Daniel completed the Form CA-16 and diagnosed 

dehydration, acute kidney injury, and metabolic and kidney leukocytosis. He checked a box 

marked “Yes” indicating that the diagnosed conditions were caused or aggravated by appellant’s 

May 5, 2021 employment injury of extreme exhaustion. 

As appellant has established that the May 5, 2021 employment incident occurred as 

alleged, the question becomes whether the incident caused an injury. As OWCP found that 

appellant had not established fact of injury, it has not evaluated the medical evidence. The Board 

will, therefore, set aside OWCP’s June 17, 2021 decision and remand the case for consideration of 

the medical evidence of record.13 After this and other such further development as deemed 

necessary, OWCP shall issue a de novo decision addressing whether appellant has met his burden 

of proof to establish an injury causally related to the accepted May 5, 2021 employment incident.14

CONCLUSION

The Board finds that this case is not in posture for decision.15

12 Id.

13 A.W., Docket No. 21-0686 (issued April5, 2022); N.A., Docket No. 21-0773 (issued December 28, 2021); see 

M.H., Docket No, 20-0576 (issued August6, 2020); S.M.,Docket No. 16-0875 (issued December 12, 2017).

14 In light of the Board’s disposition of Issue 1, Issue 2 is rendered moot.

15 The Board notes that the employing establishment issued a Form CA-16, dated May 6, 2021. 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. See 20 C.F.R. § 10.300(c); 

B.W., Docket No. 22-0134 (issued May 24, 2022); V.S., Docket No. 20-1034 (issued November 25, 2020); J.G.,

Docket No. 17-1062 (issued February 13, 2018); Tracy P. Spillane, 54 ECAB 608 (2003).
5

ORDER

IT IS HEREBY ORDERED THAT the June 17 and October 27, 2021 decisions of the 

Office of Workers’ Compensation Programs are set aside, and the case is remanded for further 

proceedings consistent with this decision of the Board. 

Issued: October 24, 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