United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

C.F., Appellant

and

U.S. POSTAL SERVICE, TALLAHASSEE 

PROCESSING & DISTRIBUTION CENTER, 

Tallahassee, FL, Employer

__________________________________________

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Docket No. 23-0290

Issued: July 12, 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

PATRICIA H. FITZGERALD, Deputy Chief Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On December 25, 2022 appellant filed a timely appeal from a November 28, 2022 merit 

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

ISSUE

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

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

1

5 U.S.C. § 8101 et seq.

2 The Board notes that following the November 28, 2022 decision, OWCP received additional evidence. 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 October 7, 2022 appellant, then a 45-year-old mail handler, filed a traumatic injury 

claim (Form CA-1) alleging that on September 2, 2022 he jarred his lower back when driving a 

forklift over cracks and bumps in the employing establishment parking lot while in the 

performance of duty. He stopped work on September 2, 2022. On the reverse side of the claim 

form, appellant’s supervisor acknowledged that appellant was injured in the performance of duty, 

but noted that he had not received any statements from appellant, except that he stated that he had 

a previous injury in 2014. 

OWCP received an October 2, 2022 authorization for examination and/or treatment (Form 

CA-16) executed by the employing establishment for treatment of appellant’s back pain. The date 

of injury was listed as September 2, 2022. In an attending physician’s report, Part B of a Form 

CA-16, dated October 14, 2022, Dr. Dan Tehle Peters, Board-certified in family medicine, related 

that appellant “injured right lower back last month picking up carboard and driving a forklift.”

Dr. Peters noted that appellant had a 2012 right lower back injury which was still occasionally 

bothering him. He diagnosed right lower back strain and radiculopathy. Dr. Peters checked a box 

marked “Yes” indicating that the condition was caused or aggravated by the described employment 

activity.

In a report dated October 14, 2022, Dr. Peters related that appellant was seen for back pain 

which began on September 2, 2022 when he was driving a forklift. He recounted that six weeks’

prior appellant injured his back while picking up cardboard and driving a forklift. Dr. Peters also 

related that appellant had a prior lower back injury in 2012, which continued to cause intermittent 

issues and occasionally miss work for a few days. He conducted an examination and diagnosed 

lower back muscle, fascia, and tendon strain and lumbar radiculopathy.

In an October 19, 2022 development letter, OWCP informed appellant of the deficiencies 

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

claim and provided a questionnaire for his completion. OWCP noted that it accepted a lumbar 

sprain due to appellant’s March 12, 2012 traumatic injury under OWCP File No. xxxxxx148, 

noting that he had not received any medical treatment for this condition since 2012. It afforded 

him 30 days to provide the necessary evidence.

OWCP subsequently received reports of a September 15, 2022 computerized tomography 

(CT) scan and September 23, 2022 magnetic resonance imaging (MRI) scan. The September 15, 

2022 lumbar CT scan indicated right L5-S1 disc protrusion and L5-S1 posterior facet degenerative 

change and hypertrophy. The September 23, 2022 MRI scan demonstrated L4-5 giant central right 

paracentral superiorly migrated extruded disc herniation impinging on the right L4 nerve root, L5-

S1 shallow right disc protrusion impinging on the right S1 nerve root, L3-4 disc bulge impinging 

on the right L3 nerve root, and multilevel lumbar degenerative facet arthrosis.

OWCP also received work status notes dated October 14 and November 4, 2022 from

Dr. Peters, which noted diagnoses of lower back muscle, fascia, and tendon strain and lumbar 

radiculopathy and provided work restrictions.

A duty status report (Form CA-17) dated November 4, 2022 from Dr. Peters noted an 

injury date of September 2, 2022 and diagnoses of lower back strain and radiculopathy, which he 
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attributed to the September 2, 2022 incident. He held appellant off work until seen by a 

neurosurgeon.

In a note dated November 28, 2022, Dr. Patricia Hogan, a physician specializing in family 

medicine, diagnosed lower lumbar strain and noted dates that treatment was provided. 

By decision dated November 28, 2022, OWCP denied appellant’s claim, finding that the 

evidence of record was insufficient to establish that the employment incident occurred, as alleged. 

It, therefore, concluded that the requirements had not been met to establish an injury as defined by 

FECA.

LEGAL PRECEDENT

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

To determine whether a federal employee has sustained a traumatic injury in the 

performance of duty, OWCP must first determine whether fact of injury has been established.

7

 

There are two components involved in establishing fact of injury. 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.

8

An injury does not have to be confirmed by eyewitnesses in order to establish the fact that 

an employee sustained an injury in the performance of duty, but the employee’s statements must 

be consistent with the surrounding facts and circumstances and his or her subsequent course of 

action.

9

 The employee has not met his or her burden of proof in establishing the occurrence of an 

3

Supra note 1.

4 C.M., Docket No. 22-0509 (issued September 28, 2022); F.H., Docket No. 18-0869 (issued January 29, 2020);

S.B., Docket No. 17-1779 (issued February 7, 2018); Joe D. Cameron, 41 ECAB 153 (1989).

5 C.M., id.; L.C., Docket No. 19-1301 (issued January 29, 2020); J.M., Docket No. 17-0284 (issued February 7, 

2018); James E. Chadden, Sr., 40 ECAB 312 (1988).

6 C.M., id.; 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).

7 G.H., Docket No. 22-0876 (issued December 2, 2022); D.B., Docket No. 18-1348 (issued January 4, 2019); S.P., 

59 ECAB 184 (2007).

8 C.M., supra note 4; T.H., Docket No. 19-0599 (issued January 28, 2020); B.M., Docket No. 17-0796 (issued 

July 5, 2018); David Apgar, 57 ECAB 137 (2005); John J. Carlone, 41 ECAB 354.

9

See C.M., id.; J.M., Docket No. 19-1024 (issued October 18, 2019); M.F., Docket No. 18-1162 (issued 

April 9, 2019).
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injury when there are such inconsistencies in the evidence as to cast serious doubt upon the validity 

of the claim.

10

 Such circumstances such 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 an employee’s 

statement in determining whether a prima facie case has been established.

11

 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 .

12

ANALYSIS

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

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

In his October 7, 2022 Form CA-1, appellant described that on September 2, 2022 he jarred 

his back while driving a forklift over cracks and bumps in the employing establishment parking 

lot. The employing establishment issued a Form CA-16 on October 2, 2022 authorizing treatment 

for the alleged September 2, 2022 incident. In addition, on October 4, 2022, Dr. Peters on Part B 

of the Form CA-16 and in his report dated October 14, 2022 described the injury as occurring 

while appellant was picking up cardboard and driving a forklift. Although OWCP found that 

appellant had submitted inconsistent descriptions regarding how the incident occurred, the Board 

finds that appellant’s further detail that he was picking up cardboard driving the forklift is not 

inconsistent with his initial statement that he sustained his back injury while driving a forklift over 

cracks and bumps in the employing establishment parking lot. 

As noted, 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.13 Appellant has consistently maintained that his injury occurred on September 2, 2022 

when he was driving a forklift over cracks and bumps in the employing establishment parking lot. 

Therefore, the Board finds that appellant has met his burden of proof to establish that a traumatic

incident occurred in the performance of duty on September 2, 2022 as alleged.14

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

September 2, 2022 as alleged, the question becomes whether the incident caused an injury.15 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.16 After 

10 C.M., id.; S.A., Docket No. 19-0613 (issued August 22, 2019); Betty J. Smith, 54 ECAB 174 (2002).

11 C.M., id.; L.D., Docket No. 16-0199 (issued March 8, 2016), Betty J. Smith, id.

12 See G.H., supra note 7; J.B., Docket No. 19-1487 (issued January 14, 2020); W.C., Docket No. 18-1651 (issued 

March 7, 2019).

13 A.C., Docket No. 18-1567 (issued April 9, 2019); D.B., 58 ECAB 529 (2007); Gregory J. Reser, 57 ECAB 

277 (2005).

14 See J.V.,Docket No. 21-0029 (issued April15, 2022);C.B., Docket No. 21-0670 (issued January 27, 2022).

15 C.B., Docket No. 21-0554 (issued June 21, 2022); C.M., Docket No. 19-0009 (issued May 24, 2019).

16 D.F., Docket No. 21-0825 (issued February 17, 2022); L.D., Docket No. 16-0199 (issued March 8, 2016).
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any further development 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 

employment incident.17

CONCLUSION

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

in the performance of duty on September 2, 2022, as alleged.18

ORDER

IT IS HEREBY ORDERED THAT the November 28, 2022 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: July 12, 2023

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

17 The Board notes that OWCP’s procedures provide that cases should be administratively combined where a new 

injury case is reported for an employee who previously filed an injury claim for the same part of the body and where 

correct adjudication depends on cross-referencing between files. See Federal (FECA) Procedure Manual, Part 2 --

Claims, File Maintenance and Management, Chapter 2.400.8c(1) (February 2000); V.G., Docket No. 19-0670 (issued 

April 30, 2020). On remand OWCP shall administratively combine File Nos. No. xxxxxx148 and xxxxxx542.

18 The Board notes that the employing establishment issued a Form CA-16. 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. The Board notes however that the Form CA-16 

issued in this case was incomplete as it did not authorize medical treatment by a specific provider. See 20 C.F.R. 

§ 10.300(c); R.C., Docket No. 22-1099 (issued December 28, 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).