United States Department of Labor

Employees’ Compensation Appeals Board

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M.S., Appellant

and

DEPARTMENT OF JUSTICE, FEDERAL 

BUREAU OF PRISONS, FEDERAL 

CORRECTIONAL INSTITUTION MEDIUM II, 

Victorville, CA, Employer

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Docket No. 23-0502

Issued: September 20, 2023

Appearances: Case Submitted on the Record

Appellant, pro se,

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On February 27, 2023 appellant filed a timely appeal from a February 22, 2023 merit

decision of the Office of Workers’ Compensation Programs (OWCP).1 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.3

1 During the pendency of this appeal, OWCP issued a June 13, 2023 decision vacating the February 22, 2023 

decision and remanding the case for further development. The Board and OWCP may not exercise simultaneous 

jurisdiction over the same issue in the same case at the same time. Thus, OWCP’s June13, 2023 decision is null and 

void. 20 C.F.R. §§ 501.2(c)(3), 10.626; A.C., Docket No. 18-1730 (issued July 23, 2019);M.C., Docket No. 18-1278, 

n.1 (issued March 7, 2019); Jacqueline S. Harris, 54 ECAB 139 (2002); RussellE. Lerman, 43 ECAB 770 (1992);

Douglas E. Billings, 41 ECAB 880 (1990).

2

5 U.S.C. § 8101 et seq.

3 The Board notes that, following the February 22, 2023 decision, OWCP received additional evidence. 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

ISSUE

The issue is whether appellant has met his burden of proof to establish a traumatic injury 

in the performance of duty on December 2, 2022, as alleged.

FACTUAL HISTORY

On December 6, 2022 appellant, then a 39-year-old education and training technician, filed 

a traumatic injury claim (Form CA-1) alleging that on December 2, 2022 he injured his back when 

he was unloading a box of books from a cart while in the performance of duty. He related that he 

developed intense pain in his back, which radiated down his leg and left him hunched over in pain 

until a staff member arrived to assist him. The claim form included the name of a witness, C.G., 

and on the reverse side of the claim form an employing establishment supervisor, T.F.,

acknowledged that appellant was injured in the performance of duty and that her knowledge of the 

facts about the injury agreed with the statements of the employee and/or witnesses. Appellant 

stopped work on December 2, 2022. 

In support of his claim, appellant submitted December 2, 2022 progress notes and urgent 

care notes from Lansdale Peters, a physician assistant, noting that he presented with moderately 

severe low back pain radiating down his left leg that began after lifting a heavy object at work that 

day. Mr. Peters assessed left-side sciatica, prescribed medication, and provided sciatica care 

instructions. In a work status report of even date, he held appellant off work and returned him to 

full-duty work on December 6, 2022. 

In December 21, 2022 progress and visit notes, Dr. Tanvir Mahtab, an occupational 

medicine specialist, noted that appellant worked in a prison facility and was injured on 

December 2, 2022 when he lifted a heavy box of books and developed back pain in his left lower 

back that radiated down his left leg. He related that appellant had prior low back pain but no prior 

low back injuries. Dr. Mahtab diagnosed low back injury and lumbar radiculopathy and indicated

that his findings and diagnoses were consistent with appellant’s account of injury or onset of 

illness. In a work status report of even date, he held appellant off work through December 26, 

2022 and placed him on modified activity from December 27, 2022 through January 10, 2023. 

In a December 23, 2022 attending physician’s report (Form CA-20), Dr. Mahtab noted a 

December 2, 2022 date of injury and diagnosed a low back injury and lumbar radiculopathy. He

related that appellant developed left lower back pain that radiated down his leg after lifting a heavy 

box of books. Dr. Mahtab checked a box marked “No”indicating that the condition was not caused 

or aggravated by the described injury. He returned appellant to light-duty work on December 27, 

2022 and provided work restrictions. 

In a January 10, 2023 visit note, Dr. Mahtab reiterated his previous diagnoses and noted 

that appellant reported difficulty walking and that his pain was persistent. In a work status report 

of even date, he provided work restrictions from January 10 to 31, 2023. 

In a January 20, 2023 development letter, OWCP informed appellant of the deficiencies of 

his claim. It advised him of the type of factual and medical evidence needed to establish his claim 

and provided a factual questionnaire for his completion. OWCP afforded appellant 30 days to 

submit the necessary evidence. 

Thereafter, appellant submitted January 10, 2023 progress notes from Dr. Mahtab 

reiterating his previous findings and diagnoses. 
3

In a January 31, 2023 work status report, Dr. Mahtab provided work restrictions through 

February 14, 2023.

A February 2, 2023 magnetic resonance imaging (MRI) scan report of appellant’s lumbar 

spine noted an impression of left paracentral disc extrusion at L5-S1 with possible impingement 

of the left S1 nerve root in the lateral recess and mild spinal canal stenosis.

A February 14, 2023 work status report from Dr. Mahtab provided work restrictions 

through March 10, 2023.

By decision dated February 22, 2023, OWCP denied appellant’s traumatic injury claim, 

finding that he had not submitted sufficient evidence to establish that the events or incident 

occurred, as alleged. Consequently, it found that he had not met the requirements to establish an 

injury as defined by FECA.

LEGAL PRECEDENT

An employee seeking benefits under FECA4 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,5that 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.6 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.7

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.8

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, 

4

Supra note 1.

5 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). 

6 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).

7 P.A., Docket No. 18-0559 (issued January 29, 2020); K.M., Docket No. 15-1660 (issued September 16, 2016); 

Delores C. Ellyett, 41 ECAB 992 (1990).

8 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).
4

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

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

statements in determining whether a prima facie case has been established.9 An employee’s 

statement alleging that an injury occurred at a given time and in a given manner is of great 

probative value and will stand unless refuted by strong or persuasive evidence. 10

ANALYSIS

The Board finds that appellant has met his burden of proof to establish a traumatic incident

in the performance of duty on December 2, 2022, as alleged.

In his December 6, 2022 Form CA-1, appellant alleged that on December 2, 2022 he 

developed intense back pain when lifting books that limited his mobility. The claim form included

the name of a witness, C.G., and on the reverse side of the claim form an employing establishment 

supervisor acknowledged that appellant was injured in the performance of duty and that her 

knowledge of the facts about the injury agreed with the statements of the employee and/or 

witnesses. 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 

persuasive evidence.11 

Further, the medical evidence contemporaneous with the alleged employment incident 

establishes that appellant sought medical treatment on December 2, 2022, the alleged date of 

injury, and reported to Mr. Peters that he developed moderately severe back pain after lifting a 

heavy object at work that day. On December 21, 2022 appellant related to Dr. Mahtab that he 

developed low back pain after lifting a heavy box of books on December 2, 2022. There are no 

inconsistencies in the evidence that cast serious doubt upon the validity of the claim, thus, the 

Board finds that appellant has established a traumatic incident in the performance of duty on 

December 2, 2022, as alleged.

As appellant has established that an incident occurred in the performance of duty on 

December 2, 2022 as alleged, the question becomes whether the incident caused an injury. 12 As

OWCP found that he had not established fact of injury, it did not evaluate the medical evidence. 

The case must, therefore, be remanded 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 December 2, 2022 employment incident.

9 C.M., Docket No. 20-1519 (issued March 22, 2021); Betty J. Smith, 54 ECAB 174 (2002).

10 See M.C., Docket No. 18-1278 (issued March 7, 2019); D.B., 58 ECAB 464, 466-67 (2007).

11 D.F., Docket No. 21-0825 (issued February 17, 2022); see also M.C., Docket No. 18-1278 (issued March 7, 

2019); D.B., 58 ECAB 464, 466-67 (2007).

12 D.F., id.; M.A., Docket No. 19-0616 (issued April10, 2020); C.M.,Docket No. 19-0009 (issued May 24, 2019).

13 D.F., id.; L.D., Docket No. 16-0199 (issued March 8, 2016); Betty J. Smith, 54 ECAB 174 (2002).
5

CONCLUSION

The Board finds that appellant has met his burden of proof to establish that a traumatic 

injury occurred in the performance of duty on December 2, 2022, as alleged.

ORDER

IT IS HEREBY ORDERED THAT the February 22, 2023 decision of the Office of 

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

consistent with this decision of the Board. 

Issued: September 20, 2023

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board