United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

J.S., Appellant

and

DEPARTMENT OF THE NAVY, MILITARY 

SEA LIFT COMMAND, Norfolk, VA, Employer

__________________________________________

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Docket No. 21-0376

Issued: September 16, 2022

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

PATRICIA H. FITZGERALD, Deputy Chief Judge

JANICE B. ASKIN, Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On January 21, 2021 appellant filed a timely appeal from a September 9, 2020 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 his burden of proof to establish a diagnosed medical

condition causally related to the accepted July 16, 2019 employment incident.

FACTUAL HISTORY

On November 14, 2019 appellant, then a 58-year-old supply utility man, filed a traumatic 

injury claim (Form CA-1) alleging that on July 16, 2019 he was on a sea vessel when a chair with 

a sharp metal frame fell on his left leg causing a puncture wound while in the performance of duty.

He did not immediately stop work.

In a letter dated November 15, 2019, the employing establishment controverted appellant’s 

claim because it was not filed within 30 days of the date of injury. OWCP also received a job 

description for a supply utility man position.

In a development letter dated November 18, 2019, OWCP notified appellant of the 

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

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

necessary evidence.

On December 5, 2019 Dr. Terry S. Schwartz, an osteopath and family medicine specialist, 

completed a medical summary form and noted that appellant presented with left lower leg 

cellulitis. Findings on examination revealed a healing avulsion laceration on the left calf and 

neuritis of both hands. Dr. Schwartz diagnosed avulsion laceration of the left ankle with cellulitis. 

He indicated that appellant was not fit for sea duty and could not work for one month. 

By decision dated December 23, 2019, OWCP denied appellant’s traumatic injury claim,

finding that the evidence of record was insufficient to establish that the injury and/or events 

occurred as he described. It explained that he had not submitted factual evidence to support that 

the employment caused the claimed medical condition. OWCP concluded, therefore, that the 

requirements had not been met to establish an injury as defined by FECA.

In a follow-up medical summary dated January 2, 2020, Dr. Schwartz noted that 

appellant’s wound was healing well, but was not completely resolved. He noted persistent neuritis 

and advised that appellant was not fit for sea duty. In a January 16, 2020 medical summary form,

Dr. Schwartz noted that appellant was not fit for sea duty and would be rechecked in two weeks.

On April 28, 2020 he diagnosed ulceration wound on left ankle and referred appellant to wound 

care for further evaluation and treatment.

In an appeal request form dated January 13, 2020, appellant requested an oral hearing 

before a representative of OWCP’s Branch of Hearings and Review. The hearing was held on 

April 27, 2020. Appellant testified that he was on deployment to the Mediterranean Sea at the 

time of the July 2019 injury and remained on the vessel until he was medically evacuated in 

October 2019. He further testified that he was treated immediately after his injury by a Navy 

corpsman, and continued receiving treatment from Navy corpsmen who rotated on/off the vessel 

until appellant was medically evacuated from the vessel.
3

On March 26, 2020 Dr. Anson Wurapa, a Board-certified internist, treated appellant and 

advised that he would not be able to return to work and would be seen in follow up on 

April 16, 2020. In an undated note, he indicated that appellant had a poorly healing ulcer on his 

left leg and would require weekly office visits along with wound care to achieve closure.

Dr. Wurapa treated appellant in follow up on May 7, 2020 and advised that appellant remained 

disabled due to a poorly healing ulcer of the left lower leg and required daily wound care. In an 

undated note, he continued appellant’s disability status due to an ulcer of the left lower leg. On 

May 21, 2020 Dr. Wurapa advised that appellant was non-weight bearing and disabled from work 

due to an open wound on the left lower ankle that required frequent dressing changes.

On April 22, 2020 appellant underwent a lower extremity venous duplex examination,

which revealed no evidence of deep vein thrombosis.

By decision dated June 5, 2020, OWCP’s hearing representative modified the 

December 23, 2019 decision to find that appellant had established that the employment incident 

occurred as alleged. However, the claim remained denied as the medical evidence of record did 

not contain a diagnosis in connection with the accepted July 16, 2019 employment incident. 

On July 8, 2020 appellant, through counsel, requested reconsideration and submitted 

additional medical evidence. 

In a March 5, 2020 report, Dr. Wurapa noted that he had treated appellant for trauma to his 

left inner ankle occurring approximately four months prior while he was on a Navy vessel.

Appellant reported many weeks of care for the ulcer without complete healing. He noted 

appellant’s history was significant for obesity and lower extremity venous insufficiency.

Dr. Wurapa debrided the wound and diagnosed traumatic ulcer to the left medial ankle that is 

nonhealing. He opined that appellant likely had underlying venous insufficiency, which may also 

be contributing to the slow wound resolution. In a follow-up report dated March 12, 2020,

Dr. Wurapa reexamined appellant for a left medial ankle ulcer, obesity, and chronic venous 

insufficiency. He noted the wound was stable, clean, and granular. Dr. Wurapa removed the dry 

skin and diagnosed left medial ankle ulcer. He advised that appellant’s wound began in a traumatic 

fashion and was nonhealing for many months. Dr. Wurapa recommended an arterial Doppler to 

further investigate the ulcer and opined that appellant may have an underlying peripheral vascular 

disease contributing to the slow healing. He further noted in a March 26, 2020 progress report that 

appellant was healing very slowly. Dr. Wurapa diagnosed left medial ankle ulcer. On April 30, 

2020 he examined appellant and diagnosed left medial lower leg venous stasis ulcer. In progress 

notes dated May 7 and 14, 2020, Dr. Wurapa noted the left medial ankle ulcer decreased in size 

and had no significant depth. He debrided the wound and provided a compression wrap. 

Dr. Wurapa diagnosed left medial ankle venous stasis ulcer.

Dr. Alexandra Dretler, a Board-certified internist, evaluated appellant on April 16, 2020 

for chronic nonhealing venous stasis ulcer with some component of peripheral arterial disease. 

She noted a wound on the left medial ankle with a primary etiology of venous leg ulcer and 

secondary etiology of lymphedema. Dr. Dretler excised the skin, subcutaneous tissue, and fibrosis 

with minimal bleeding. She diagnosed nonhealing skin ulcer, lymphedema, and peripheral arterial 

disease. 
4

On May 27, 2020 Dr. Hieu Nguyen, Board-certified in infectious disease and internal 

medicine, treated appellant for a venous stasis ulcer on his left leg after a traumatic wound. She

noted findings on examination of a mostly dermatitis medial ankle left leg wound. Dr. Nguyen 

diagnosed venous stasis ulcer and recommended compression stockings. She released appellant 

to work and discharged him from the clinic. In an undated note, Dr. Nguyen advised that the left 

lower leg wound resolved on May 27, 2020 and appellant could return to work without restrictions.

Appellant was treated by Dr. Mohammed Khan, a Board-certified vascular surgeon, on 

June 3, 2020, who diagnosed left leg ulcer.

Dr. Schwartz treated appellant on July 15, 2020 and released him to work.

By decision dated September 9, 2020, OWCP denied modification of its June 5, 2020

decision.

LEGAL PRECEDENT

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 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 actually sustained an injury in the performance 

of duty, OWCP begins with an analysis of whether fact of injury has been established. Generally, 

fact of injury consists of two components, which must be considered in conjunction with one 

another. The first component to be established is that the employee actually experienced the 

employment incident at the time and place and in the manner alleged.7 The second component is 

whether the employment incident caused a personal injury and generally can be established only 

by medical evidence.8

3

Supra note 2.

4

S.B.,Docket No. 17-1779 (issued February 7, 2018); J.P., 59 ECAB 178 (2007); Joe D. 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 K.M.,Docket No. 15-1660 (issued September 16, 2016); L.M.,Docket No. 13-1402 (issued February 7, 2014);

DeloresC. Ellyett, 41 ECAB 992 (1990).

7

Id.; Elaine Pendleton, 40 ECAB 1143 (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).
5

The medical evidence required to establish causal relationship between a claimed specific 

condition and an employment incident is rationalized medical opinion evidence.9 The opinion of 

the physician must be based on a complete factual and medical background of the claimant, 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 the specific employment incident 

identified by the claimant.10

ANALYSIS

The Board finds that appellant has met his burden of proof to establish an avulsion wound 

and ulcer of the left ankle causally related to the accepted July 16, 2019 employment incident.

OWCP found that the July 16, 2019 employment incident occurred in the performance of 

duty, as alleged. Medical records dated December 5, 2019 from Dr. Schwartz diagnosed avulsion 

laceration of the left ankle with cellulitis. On April 28, 2020 he diagnosed ulceration wound on 

left ankle. Similarly, Dr. Wurapa indicated that appellant had a poorly healing ulcer on his left leg 

and would require weekly office visits along with wound care to achieve closure. He treated 

appellant in follow up on May 7, 2020 and advised that appellant remained disabled due to a poorly 

healing ulcer of the left lower leg. Likewise, in reports dated May 27 and June 3, 2020,

Drs. Nguyen and Khan treated appellant for a venous stasis ulcer on his left leg after a traumatic 

wound.

As the evidence of record establishes that appellant’s employment incident resulted in a 

visible injury, the Board finds that he has met his burden of proof to establish an avulsion wound 

and ulcer of the left ankle causally related to the accepted July 16, 2019 employment incident.11 

The case will, therefore, be remanded for payment of medical expenses for appellant’s diagnosed 

avulsion wound and ulcer of the left ankle, to be followed by a de novo decision regarding any 

attendant disability.

The Board further finds, however, that appellant has not established additional conditions

as causally related to the accepted employment injury. 

Dr. Dretler evaluated appellant on April 16, 2020 for chronic nonhealing venous stasis 

ulcer with some component of peripheral arterial disease. In addition to nonhealing skin ulcer, she

also diagnosed lymphedema, and peripheral arterial disease. However, Dr. Dretler did not provide 

an opinion on causal relationship between the additional diagnosed conditions and the accepted 

employment injury. The Board has held that medical evidence that does not offer an opinion 

9 M.S.,Docket No. 19-1096 (issued November 12, 2019); Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000).

10 R.S., Docket No. 19-1484 (issued January 13, 2020); Leslie C. Moore, 52 ECAB 132 (2000).

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

July 22, 2020).
6

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

relationship.12 This report is, therefore, insufficient to meet appellant’s burden of proof.

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 and 20 C.F.R. 

§§ 10.605 through 10.607.

CONCLUSION

The Board finds that appellant has met his burden of proof to establish an avulsion wound 

and ulcer causally related to the accepted July 16, 2019 employment incident. The Board further 

finds, however, that he has not met his burden of proof to establish additional conditions as causally 

related to the accepted employment injury.

ORDER

IT IS HEREBY ORDERED THAT the September 9, 2020 decision of the Office of 

Workers’ Compensation Programs is reversed in part and affirmed in part.

Issued: September 16, 2022

Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

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