United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

C.S., Appellant

and

DEPARTMENT OF VETERANS AFFAIRS, 

DORIS MILLER VA MEDICAL CENTER, 

Waco, TX, Employer

__________________________________________

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Docket No. 21-0560

Issued: July 13, 2023

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 February 26, 2021 appellant filed a timely appeal from a November 12, 2020 merit 

decision and a February 4, 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 a diagnosed 

medical condition in connection with the accepted September 21, 2020 employment incident; and 

1

5 U.S.C. § 8101 et seq.

2 The Board notes that following the February4, 2021 decision, appellant submitted additional evidence to 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 appea l. Id.
2

(2) whether OWCP properly denied appellant’s request for an oral hearing as untimely filed,

pursuant to 5 U.S.C. § 8124(b).

FACTUAL HISTORY

On September 29, 2020 appellant, then a 59-year-old laundry worker, filed a traumatic 

injury claim (Form CA-1) alleging that on September 21, 2020 she was struck on the left side of 

her face with a closed fist by a coworker who began speaking profanities and threateningher while 

in the performance of duty. On the reverse side of the claim form, L.D., appellant’s supervisor, 

contended that the injury was due to willful misconduct as the two employees were trying to fist 

fight each other. L.D. reported that appellant was in a verbal confrontation with a coworker and 

both employees swung at each other. Appellant did not stop work.

In a duty status report (Form CA-17) dated October 2, 2020, Dr. Gilbert Mayorga, a Boardcertified family medicine specialist, noted a September 21, 2020 employment incident when 

appellant was assaulted by a coworker and hit on her left cheek. He described clinical f indings 

and diagnosed facial contusion. 

In a letter dated October 7, 2020, the employing establishment controverted appellant’s 

claim, contending that she had not established fact of injury or provided a medical report 

establishing a diagnosed condition in connection to the employment incident. 

In a September 21, 2020 narrative statement, appellant reported that following an employee 

meeting, her coworker, began yelling profanities at her, ran towards her, and hit her in the lip. She 

related that staff members grabbed both of them and the coworker picked up a piece of the ice box,

which she used to try to swing at her. Appellant reported that she called the VA police and 

provided a statement immediately following the incident.

A number of witness statements were also submitted describing the September 21, 2020

employment incident between appellant and a coworker, including statements from appellant, and 

witnesses.

In an October 7, 2020 development letter, OWCP informed appellant of the deficiencies of 

her claim. It advised her as to the type of factual and medical evidence required and provided a 

questionnaire for her completion. OWCP afforded appellant 30 days to respond.

OWCP received additional evidence including an October 29, 2020 response to OWCP’s 

development questionnaire, wherein appellant further described the circumstances surrounding the 

alleged September 21, 2020 employment incident. 

OWCP also received an undated witness statement, wherein S.V., appellant’s supervisor, 

related the events of the alleged September 21, 2020 employment incident.

By decision dated November 12, 2020, OWCP accepted that appellant had established that 

the September 21, 2022 employment incident occurred, as alleged. However, it denied her claim,

finding that the medical evidence of record was insufficient to establish a medical diagnosis in 

connection with the accepted September 21, 2020 employment incident.
3

OWCP subsequently received an October 2, 2020 medical report from Dr. Mayorga, who 

discussed his initial consultation with appellant on that date following an alleged September 21, 

2020 employment incident when she was struck in the face by a coworker with a closed fist.

Appellant complained of headaches, pain, soreness, and swelling of her left cheek, and anxiety at 

work due to fear of being attacked again. He noted physical examination findings of minimal 

swelling of the left facial malar surface area with no bruising, minimal discomfort to the cheek to 

palpation, and essentially unremarkable balance of facial and neurologic examination.

Dr. Mayorga diagnosed facial contusion, post-traumatic headaches, and post-traumatic stress 

disorder (PTSD). He recommended x-rays of the face, a magnetic resonance imaging (MRI) scan 

of the brain to rule out a concussion, and restricted appellant from returning to work pending test 

results. 

In a November 23, 2020 Form CA-17, Dr. Mayorga restricted appellant from returning to 

work. 

On January 14, 2021 appellant requested an oral hearing before a representative of 

OWCP’s Branch of Hearings and Review. In support of her claim, she submitted an additional 

September 21, 2020 narrative statement describing the circumstances surrounding her injury, and 

a January 6, 2021 Form CA-17 from Dr. Mayorga further restricting appellant from returning to 

work.

By decision dated February 4, 2021, OWCP denied appellant’s request for an oral hearing

as untimely filed, finding that her request was not made within 30 days of the November 12, 2020 

decision as it was received on January 14, 2021. It further exercised discretion and determined 

that the issue in this case could equally well be addressed through a request for reconsideration 

before OWCP along with the submission of new evidence.

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 

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

3

Supra note 1.

4 E.K., Docket No. 22-1130 (issued December 30, 2022); F.H., Docket No. 18-0869 (issued January 29, 2020);

J.P., Docket No. 19-0129 (issued April 26, 2019); Joe D. Cameron, 41 ECAB 153 (1989).

5

S.H., Docket No. 22-0391 (issued June 29, 2022); 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 E.H., Docket No. 22-0401 (issued June 29, 2022); P.A., Docket No. 18-0559 (issued January29, 2020);

K.M., Docket No. 15-1660 (issued September 16, 2016); Delores C. Ellyett, 41 ECAB 992 (1990). 
4

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. 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. Second, the employee must 

submit sufficient evidence to establish that the employment incident caused a personal injury. 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

Pursuant to OWCP’s procedures, no development of a claim is necessary where the 

condition reported is a minor one, which can be identified on visual inspection by a lay person 

(e.g., burn, laceration, insect sting, or animal bite).10 No medical report is required to establish a

minor condition such as a contusion.11

ANALYSIS -- ISSUE 1

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

causally related to the accepted September 21, 2020 employment incident.

In a Form CA-17 dated October 2, 2020, Dr. Mayorga noted a September 21, 2020 injury 

when appellant was assaulted by a coworker and hit on her left cheek. He described clinical 

findings and diagnosed facial contusion. OWCP’s procedures provide that, if a condition reported 

is a minor one, such as a burn, laceration, insect sting, or animal bite, which can be identified on 

visual inspection by a lay person, a case may be accepted without a medical report. 12 As the 

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

7 H.M., Docket No. 22-0343 (issued June 28, 2022); T.J., Docket No. 19-0461 (issued August 11, 2020);

K.L., Docket No. 18-1029 (issued January 9, 2019); John J. Carlone, 41 ECAB 354 (1989). 

8

S.M., Docket No. 22-0075 (issued May 6, 2022); S.S., Docket No. 19-0688 (issued January 24, 2020);

A.M., Docket No. 18-1748 (issued April 24, 2019); Robert G. Morris, 48 ECAB 238 (1996).

9

J.D., Docket No. 22-0935 (issued December 16, 2022); 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).

10 Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.800.6a (June2011). See 

also Chapter 2.805.3c (January 2013); A.J., Docket No. 19-1289 (issued December 31, 2019).

11 Id.; see B.C., Docket No. 20-0498 (issued August27, 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).

12 Id.; see also S.G., Docket No. 22-0016 (issued October 31, 2022).
5

the Board finds that she has met her burden of proof to establish a facial contusion causally related 

to the accepted September 21, 2020 employment incident.13

Accordingly, the November 12, 2020 decision is reversed to find that the claim is accepted 

for facial contusion.

14

 The case shall therefore be remanded to OWCP for payment of medical 

expenses for appellant’s diagnosed contusion.15

CONCLUSION

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

causally related to the accepted September 21, 2020 employment incident.

ORDER

IT IS HEREBY ORDERED THAT the November 12, 2020 decision of the Office of 

Workers’ Compensation Programs is reversed.16 The case is remanded for further proceedings 

consistent with this decision.

Issued: July 13, 2023

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

13 J.B., Docket No. 21-1322 (issued April 4, 2022). 

14 T.A., Docket No. 22-0955 (issued December 16, 2022).

15 U.S., Docket No. 22-0461 (issued March 13, 2023).

16 Given the disposition of the first issue, the second issue is rendered moot.