United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

C.V., Appellant

and

DEPARTMENT OF VETERANS AFFAIRS, 

DALLAS VA MEDICAL CENTER, Dallas, TX, 

Employer

__________________________________________

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Docket No. 22-0078

Issued: November 28, 2022

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

PATRICIA H. FITZGERALD, Deputy Chief Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On October 26, 2021 appellant filed a timely appeal from a June 17, 2021 merit decision

and August 30, 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 her burden of proof to establish causal 

relationship between a diagnosed medical condition and the accepted compensable employment 

1

5 U.S.C. § 8101 et seq.

2 The Board notes that, following the August 30, 2021 decision, appellant submitted additional evidence to OWCP. 

However, the Board’s Rules of Procedures 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

factor; and (2) whether OWCP properly denied appellant’s request for reconsideration of the 

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

FACTUAL HISTORY

On November 17, 2020 appellant, then a 54-year-old registered nurse, filed a traumatic 

injury claim (Form CA-1) alleging that on October 25, 2020 she developed a sudden onset of 

blurry vision and eye floaters while in the performance of duty. She explained that on October 25, 

2020 she was the charge nurse and called the emergency room regarding the transfer of a patient 

with COVID-19 when an altercation occurred among subordinate employees regarding the 

transfer. Appellant’s blood pressure increased,she experienced blurred vision, and eye floaters. 

On the reverse side of the claim form, the employing establishment noted that she stopped work 

on October 25, 2020.

On October 25, 2020 Dr. Michael Fulton, a family practitioner, treated appellant at an 

urgent care clinic and diagnosed hypertensive urgency.

On October 25, 2020 appellant was also treated in the emergency room by Dr. Grace 

Allawirdi, Board-certified in emergency medicine, for hypertension, loss of vision, shortness of 

breath, and vitreous hemorrhage. In a work excuse note of even date, she returned appellant to 

work on October 27, 2020.

On October 25, 2020 D.F., a human resource specialist for the employing establishment, 

challenged appellant’s claim. She alleged that appellant had preexisting hypertension, which 

caused her blurred vision. D.F. noted that appellant underwent right eye surgery on 

October 27, 2020.

On October 27, 2020 Dr. Vijay Khetpal, a Board-certified ophthalmologist, diagnosed a 

detached retina of the right eye. He performed a vitrectomy of the right eye. In a work excuse 

note of even date, Dr. Khetpal returned appellant to full-duty work as of November 6, 2020. In a 

November 2, 2020 note, he released appellant to full-duty work as of December 21, 2020.

In a November 23, 2020 development letter, OWCP informed appellant of the deficiencies 

of her claim. It advised her of the type of additional factual and medical evidence needed and 

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

necessary evidence.

OWCP subsequently received a clinical summary from Dr. Fulton on October 25, 2020,

indicating that appellant presented with a chief complaint of blurry vision, floaters in the left eye, 

and a cough. She reported a history of hypertension, diabetes, and exposure to COVID-19 positive 

patients. Dr. Fulton diagnosed hypertensive urgency.

In an emergency room discharge summary dated October 25, 2020, Dr. Allawirdi 

diagnosed hypertension, established; loss of vision;shortness of breath; and vitreous hemorrhage. 

She noted that appellant presented to the emergency room on October 25, 2020 with hypertension 

elevated in the 200’s with a sudden onset of blurred vision in the right eye. A computerized

tomography (CT) scan of the head/brain revealed no acute intracranial abnormality and appellant’s
3

laboratory testing was negative. A bedside ocular ultrasound showed a small vitreous hemorrhage 

and a questionable vitreous detachment. Dr. Allawirdi noted that appellant’s blood pressure had 

improved and she was discharged home with a referral to an ophthalmologist.

OWCP also received an undated witness statement from R.S., a registered nurse, who 

worked with appellant on October 25, 2020. R.S. indicated that appellant was the charge nurse 

and at 12:15 p.m. a sudden verbal confrontation took place between a nursing assistant and another 

nurse, about who would accompany a COVID-19 patient to the emergency room. She indicated 

that appellant was on the telephone with the emergency room facilitating the transfer, when another 

nurse also barged toward her screaming aggressively, and questioning why the patient’s transport 

was delayed. R.S. noted that, after the patient was transported, appellant reported “three blows to 

her heart,” she was feeling uneasy, had blurry vision, and experienced floating in her eyes that 

obscured her vision. Appellant reported her condition to the clinical coordinator, G.M., and was 

on sick leave the rest of the day.

Appellant was treated by Dr. Prasad V. Maddukuri, a Board-certified cardiologist, on 

December 3, 2020 who performed a pharmacological myocardial perfusion study, which was 

found to be normal. Similarly, an echocardiogram of even date was normal. On December 30, 

2020 Dr. Maddukuri noted that appellant was off work for four weeks due to high blood pressure 

and retinal detachment.

On December 4, 2020 Dr. Khetpal diagnosed vitreous hemorrhage and a retinal tear. He 

related that on October 27, 2020 he performed a vitrectomy with endolaser and gas injection. 

Dr. Khetpal noted that he could not determine the causality from appellant’s history or 

examination. On December 18, 2020 he noted that, after surgery, appellant would be on restricted 

duty for three months due to vision impairment in the right eye.

In a written statement dated December 15, 2020, appellant indicated that on October 25, 

2020 she was the charge nurse and her tour of duty was from 7:30 a.m. to 8:00 p .m. She noted 

that at about 12:15 p.m. an altercation occurred between subordinate employees regarding the 

transfer of a COVID-19 patient to the emergency room. Appellant was on the telephone giving a 

report to the emergency room when one of the nursing assistants who was pushing the veteran to 

the emergency room came back unexpectedly, raised her voice, and removed her gown, stating 

that it was not her patient and she was not going to the emergency room. She indicated that she 

could not see the nursing assistant, due to a pillar in the nurses’ pod. A nurse started yelling back,

but she could not see him because of the wall. Appellant noted that a third person came from 

behind her and yelled at her about transporting the COVID-19 veteran. She noted that due to the 

loud noises from three unseen persons from three different directions caused a sudden blow-like 

feeling to her heart. Appellant indicated that she was hypertensive, but her condition was well 

controlled with blood pressure medication. She reported heaviness between her shoulder blades, 

she had a sudden onset of blurred vision in both eyes, and floating in the visual field. Appellant 

proceeded to her computer to submit the transfer notes and had difficulty completing the task. She 

thought that perhaps her eye became infected when treating a COVID-19 patient. Appellant

informed the clinical coordinator and nurse manager of her condition and left work at 12:30 p.m. 

Her son took her to urgent care where the physician informed her that her blood pressure was 

200/120 and referred her to the emergency room. Appellant underwent emergency eye surgery on 

October 27, 2020. She asserts that her eye injury occurred on October 25, 2020 as a result of 
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sudden loud noises and stress. Appellant indicated that she did not sustain any other injury on or 

off duty between the date of injury and the date it was reported and she did not experience similar 

symptoms prior to this incident. 

By decision dated December 31, 2020, OWCP denied appellant’s traumatic injury claim, 

finding that the medical evidence submitted was insufficient to establish causal relationship 

between her diagnosed conditions and the accepted employment incident.

OWCP received additional evidence. On October 26, 2020 Dr. Khetpal treated appellant 

for sudden onset of blurred vision, chest tightness, and elevated blood pressure. He diagnosed 

retinal tear with vitreous hemorrhage, bleeding, and infection. On November 2, 2020 Dr. Khetpal

treated appellant in follow up and noted eye irritation. He related, in reports dated January 4 and 

April 5, 2021, that appellant was doing well and the vitreous hemorrhage resolved. On April 6, 

2021 Dr. Khetpal advised that, due to the long-lasting effects of the October 27, 2020 eye surgery,

he recommended appellant’s hours be reduced to eight hours a day.

OWCP received medical records from January 22 through February 4, 2021, regarding the 

employing establishment’s evaluation of appellant for return-to-work clearance.

On January 26, 2021 appellant requested an oral hearing before a representative of 

OWCP’s Branch of Hearings and Review. A hearing was held on April 13, 2021.

On March 8, 2021 Dr. Ruby Anthony-White, a Board-certified internist and an employing 

establishment physician, reported treating appellant on January 22, 2021. Appellant presented

emotionally affected by “yelling” coming from a coworker while she was on the telephone at work. 

She reported a few minutes later experiencing palpatations and blurry vision in both eyes, but 

mostly in the right eye. Appellant immediately sought treatment from an urgent care clinic, which 

reported her blood pressure was 209/120 and referred her to the emergency room. The healthcare 

providers diagnosed a vitreous hemorrhage in the right eye. On October 27, 2020 appellant

underwent surgery to repair the retinal detachment. She continued to experience diminished 

vision, which has since improved. Dr. Anthony-White diagnosed hypertension aggravated by 

stress, reaction to severe stress, vitreous hemorrhage, and right retinal detachment. She opined 

that appellant had a reaction to severe stress at work, specifically, stress of loud talking by 

coworkers while trying to manage COVID-19 cases. Dr. Anthony-White further noted that it was 

not clear what caused the right eye retinal detachment as most cases were spontaneous, or related 

to trauma or diabetes.

By decision dated June 17, 2021, OWCP’s hearing representative modified the 

December 31, 2020 decision to accept that appellant’s reaction to the subordinate employees 

shouting about transferring a COVID-19 patient constituted a compensable employment factor as 

it involved her performing her duties as a charge nurse, but denied appellant’s claim, finding that 

the medical evidence of record was insufficient to establish that the accepted compensable 

employment factor caused her diagnosed conditions.

On August 6, 2021 appellant requested reconsideration. She contended that OWCP’s 

hearing representative mischaracterized the issue; that the basis for the December 30, 2021 

decision was incorrect; and that OWCP failed to analyze medical evidence.
5

By decision dated August 30, 2021, OWCP denied appellant’s request for reconsideration 

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

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 the fact that the individual is an employee of the 

United States within the meaning of FECA, that the claim was filed within the applicable time 

limitation of FECA, that an injury was sustained in the performance of duty, as alleged, and that 

any disability or specific condition for which compensation is claimed is causally related to the 

employment injury. 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.4

To establish a claim for an emotional condition in the performance of duty, an employee 

must submit: (1) factual evidence identifying employment factors or incidents alleged to have 

caused or contributed to his or her condition; (2) medical evidence establishing that he or she has 

an emotional or psychiatric disorder; and (3) rationalized medical opinion evidence establishing 

that the identified compensable employment factors are causally related to his or her emotional 

condition or psychiatric disorder.

5

A claimant has the burden of proof to establish by the weight of the reliable, probative, and 

substantial evidence that the condition for which he or she claims compensation was caused or 

adversely affected by employment factors.6 This burden includes the submission of a detailed 

description of the employment factors or conditions, which he or she believes caused or adversely 

affected a condition for which compensation is claimed, and a rationalized medical opinion 

relating the claimed condition to compensable employment factors.7

Causal relationship is a medical question that generally requires rationalized medical 

opinion evidence to resolve the issue.8 A physician’s opinion on whether there is causal 

relationship between the diagnosed condition and the implicated employment factor(s) must be 

based on a complete factual and medical background.9 Additionally, the physician’s opinion must 

be expressed in terms of a reasonable degree of medical certainty, and must be supported by 

3

5 U.S.C. § 8101 et seq.

4 M.H., Docket No. 19-0930 (issued June17, 2020); Gary J. Watling, 52 ECAB 357 (2001).

5 R.B., Docket No. 19-0343 (issued February 14, 2020).

6 B.S., Docket No. 19-0378 (issued July 10, 2019); PamelaR. Rice, 38 ECAB 838 (1987).

7 P.B., Docket No. 17-1912 (issued December 28, 2018); Effie O. Morris, 44 ECAB 470 (1993).

8

28 ECAB 125 (1976).

9 M.V., Docket No. 18-0884 (issued December 28, 2018); Victor J. Woodhams, 41 ECAB 345, 352 (1989).
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medical rationale, explaining the nature of the relationship between the diagnosed condition and 

appellant’s specific employment factor(s).10

ANALYSIS -- ISSUE 1

The Board finds that appellant has not met her burden of proof to establish causal 

relationship between a diagnosed medical condition and the accepted compensable employment 

factor.

On October 25, 2020 Dr. Fulton treated appellant for blurred vision, floaters in the left eye, 

and a cough. He diagnosed hypertensive urgency. Appellant was also treated in the emergency 

room on October 25, 2020 by Dr. Allawirdi for hypertension, loss of vision, shortness of breath, 

sudden onset of blurred vision in the right eye, and vitreous hemorrhage. In a work excuse note

of even date, she returned appellant to work on October 27, 2020. Similarly, on October 26, 2020

Dr. Khetpal treated appellant for sudden onset of blurred vision, chest tightness, and elevated blood 

pressure. He diagnosed retinal tear with vitreous hemorrhage, bleeding, and infection. Dr. Khetpal 

performed a vitrectomy of the right eye on October 27, 2020. In work excuse notes dated 

October 27, November 2, and December 18, 2020, he noted that appellant would be on restricted 

duty after surgery. On December 4, 2020 Dr. Khetpal diagnosed vitreous hemorrhage and a retinal 

tear and opined that he could not determine the causality from appellant’s history or examination. 

He related in reports dated January 4, and April 5 and 6, 2021 that the vitreous hemorrhage 

resolved, but, due to the long-lasting effects of the October 27, 2020 eye surgery, he recommended 

appellant’s hours be reduced. Likewise, in reports dated December 3 and 30, 2020, Dr. Maddukuri 

noted that appellant was off work for four weeks due to high blood pressure and retinal detachment. 

However, in these reports, Drs. Fulton, Allawirdi, Khetpal, and Maddukuri offered no opinion as 

to a causal relationship between the accepted October 25, 2020 compensable factor and her 

diagnosed conditions. The Board has held that medical evidence that does not offer an opinion 

regarding the cause of an employee’s condition is of no probative value on the issue of causal 

relationship.11 These reports, therefore, are insufficient to establish appellant’s claim.

On March 8, 2021 Dr. Anthony-White noted that appellant presented emotionally affected 

by “yelling” coming from a coworker while she was on the telephone at work and diagnosed 

hypertension aggravated by stress, reaction to severe stress, vitreous hemorrhage, and right retinal 

detachment. She opined that appellant had a reaction to severe stress at work, specifically, stress 

of loud talking by coworkers while trying to manage COVID-19 cases. The Board finds that, 

although Dr. Anthony-White supported causal relationship, she did not provide medical rationale 

explaining the basis of her conclusory opinion regarding causal relationship between appellant’s 

diagnosed conditions and the accepted October 25, 2020 compensable factor.12 Therefore, this 

report is insufficient to meet appellant’s burden of proof.

10 Id.

11 See L.B., Docket No. 18-0533 (issued August 27, 2018); D.K.,Docket No. 17-1549 (issued July 6, 2018).

12 See T.M., Docket No. 08-0975 (issued February 6, 2009) (a medical report is of limited probative value on the 

issue of causal relationship if it contains a conclusion regarding causal relationship,which is unsupported by medical 

rationale).
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As the medical evidence of record is insufficient to establish causal relationship between a 

diagnosed condition and the accepted compensable employment factor, the Board finds that she 

has not met her burden of proof to establish her claim.

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 FECA 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 compensation at any time on his or her own motion or on application.13

To require OWCP to reopen a case for merit review pursuant to FECA, the claimant must 

provide evidence or an argument which: (1) shows that OWCP erroneously applied or interpreted 

a specific point of law; (2) advances a relevant legal argument not previously considered by 

OWCP; or (3) constitutes relevant and pertinent new evidence not previously considered by 

OWCP.14

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

OWCP’s decision for which review is sought.15 If it chooses to grant reconsideration, it reopens 

and reviews the case on its merits.16 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.17

ANALYSIS -- ISSUE 2

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

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

Appellant has not alleged or demonstrated that OWCP erroneously applied or interpreted 

a specific point of law. With regard to the second requirement, she contended that OWCP’s 

hearing representative mischaracterized the issue; that the basis for the December 30, 2021 

13 Supra note 1 at § 8128(a); see M.S.,Docket No. 19-1001 (issued December 9, 2019); L.D., Docket No. 18-1468 

(issued February 11, 2019); see also V.P., Docket No. 17-1287 (issued October 10, 2017); W.C., 59 ECAB 372 (2008).

14 20 C.F.R. § 10.606(b)(3); see L.D., id.; see also K.L., Docket No. 17-1479 (issued December 20, 2017); C.N.,

Docket No. 08-1569 (issued December 9, 2008).

15 Id. at § 10.607(a). The one-year period begins on the next day after the date of the original contested decision. 

Federal (FECA) Procedure Manual, Part 2 -- Claims, Reconsiderations, Chapter 2.1602.4 (September 2020). 

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.

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

17 Id. at § 10.608(b); M.S., Docket No. 19-0291 (issued June 21, 2019); E.R., Docket No. 09-1655 (issued 

March 18, 2010).
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decision was incorrect; and that OWCP failed to analyze medical evidence. However, appellant’s 

arguments lack a reasonable color of validity. The Board has held that where a legal argument 

presented has no reasonable color of validity, OWCP is not required to reopen the case for merit 

review.18 Consequently, appellant is not entitled to a review of the merits of her claim based on 

the first and second above-noted requirements under 20 C.F.R. § 10.606(b)(3).19 

Further, appellant did not submit relevant and pertinent new evidence in support of her 

request for reconsideration under 20 C.F.R. § 10.606(b)(3). The underlying issue is whether 

appellant submitted sufficient medical evidence to establish a medical condition causally related 

to the accepted October 25, 2020 compensable employment factor. This is a medical issue, which 

must be determined by rationalized medical evidence.20 However, appellant did not submit any 

additional medical evidence in support of her reconsideration request. As appellant did not submit 

relevant and pertinent new medical evidence not previously considered by OWCP, she is not 

entitled to further merit review under the third requirement of 20 C.F.R. § 10.606(b)(3).

The Board, accordingly, finds that appellant did not meet any of the requirements of 20 

C.F.R. § 10.606(b)(3). Pursuant to 20 C.F.R. § 10.608, OWCP properly denied merit review.

CONCLUSION

The Board finds that appellant has not met her burden of proof to establish causal 

relationship between a diagnosed medical condition and the accepted compensable employment 

factor. The Board further finds that OWCP properly denied appellant’s request for reconsideration 

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

18 S.B., Docket No. 20-0708 (issued February 11, 2022); C.N., Docket No. 17-1475 (issued May 23, 2018);see 

D.F., Docket No. 17-0694 (issued June 22, 2017); D.T., Docket No. 14-1239 (issued December 9, 2014);

Constance G. Mills, 40 ECAB 317 (1988).

19 M.O., Docket No. 19-1677 (issued February 25, 2020); C.B., Docket No. 18-1108 (issued January 22, 2019).

20 See Bobbie F. Cowart, 55 ECAB 746 (2004).
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ORDER

IT IS HEREBY ORDERED THAT the June 17 and August 30, 2021 decisions of the 

Office of Workers’ Compensation Programs are affirmed.

Issued: November 28, 2022

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board