United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

S.H., Appellant

and

U.S. POSTAL SERVICE, PROCESSING & 

DISTRIBUTION CENTER/FACILITY, 

Milan, IL, Employer

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Docket No. 23-0363

Issued: September 20, 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

VALERIE D. EVANS-HARRELL, Alternate Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On January 16, 2023 appellant filed a timely appeal from a September 7, 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

1

5 U.S.C. § 8101 et seq.

2 The Board notes that, following the September 7, 2022 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 appeal. Id.
2

ISSUE

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

in the performance of duty on July 28, 2022, as alleged. 

FACTUAL HISTORY

On July 29, 2022 appellant, then a 30-year-old mail processing clerk, filed a traumatic 

injury claim (Form CA-1) alleging that on July 28, 2022 she sustained an injury to her left shoulder

when she was pulling out gaylord mail containers with a pallet jack while in the performance of 

duty. She indicated that she pulled on what she thought was a lowered pallet and turned at the 

same time, causing a pop in her left shoulder and pain throughout her left arm, which worsened 

throughout the night. On the reverse side of the claim form, appellant’s supervisor, J.S.,

acknowledged that the injury occurred in the performance of duty. Appellant stopped work on 

July 29, 2022, and returned to work on August 1, 2022. The employing establishment alleged that 

she injured herself due to willful misconduct as she failed to use proper workplace procedures in 

removing gaylords from the machine. 

In an August 3, 2022 development letter, OWCP informed appellant of the deficiencies of 

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

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

In support of her claim, appellant submitted a July 29, 2022 hospital report from

Dr. Matthew D. Hanson, an emergency medicine physician. Dr. Hanson reported that she

presented to the emergency department for shoulder pain. Appellant reported that, the prior

evening at work, she was lifting boxes with a pallet holder, which she thought was on the ground 

completely, but in fact was not, causing her to drop the boxes. She reported feeling a pop and 

intense pain in her left shoulder. Appellant described experiencing numbness down her arm and 

shoulder blade, with the pain worsening the following day. Physical examination findings revealed 

tenderness over the posterior left shoulder blade. X-rays of the left shoulder revealed no evidence 

of acute left shoulder fracture, no dislocation, intact acromioclavicular and glenohumeral joints, 

and postoperative changes of the median sternotomy. Dr. Hanson diagnosed acute pain of the left 

shoulder, recommended wearing a sling, and provided follow-up instructions upon discharge of 

appellant. 

An undated attending physician’s report, Part B of an authorization for examination and/or 

treatment (Form CA-16), discussed the first examination of appellant on July 29, 2022 for her left 

shoulder employment incident. Recommendations were provided for orthopedics to treat the left 

shoulder torn cartilage. 

By decision dated September 7, 2022, OWCP denied appellant’s traumatic injury claim,

finding that the evidence of record was insufficient to establish that the July 28, 2022 employment 

incident occurred, as alleged. It concluded, therefore, that the requirements had not been met to 

establish an injury as defined by FECA.
3

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, 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, place, and in the manner alleged. Second, the employee must 

submit sufficient evidence to establish that the employment incident caused a personal injury. 7

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.8 The employee has not met his or her burden of proof to establish the occurrence of an 

injury when there are inconsistencies in the evidence that cast serious doubt upon the validity of 

the claim. Such circumstances 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 statements 

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

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

3

Id.

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 January 29, 2020);

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

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 M.F., Docket No. 18-1162 (issued April 9, 2019); Charles B. Ward, 38 ECAB 667-71 (1987).

9 K.H., Docket No. 22-0370 (issued July 21, 2022); BettyJ. Smith, 54 ECAB 174 (2002); see also L.D., Docket No. 

16-0199 (issued March 8, 2016).

10 See K.H., id.; M.C., Docket No. 18-1278 (issued March 7, 2019); D.B., 58 ECAB 464, 466-67 (2007).
4

ANALYSIS

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

incident occurred in the performance of duty on July 28, 2022, as alleged.

As noted above, an employee’s statement alleging that an injury occurred at a given time,

place, and in a given manner, is of great probative value and will stand unless refuted by strong or 

persuasive evidence.11 Appellant alleged that she sustained a left shoulder injury on July 28, 2022 

when she was pulling out gaylord mail containers with a pallet jack that she thought was lowered 

and turned at the same time, causing a pop in her left shoulder and pain throughout her left arm. 

She described the incident on her July 29, 2022 Form CA-1, promptly notified her supervisor, and 

sought emergency medical treatment the following day. Appellant also provided reports from an

emergency department dated July 29, 2022, the day immediately following the employment

incident. Dr. Hanson’s history of injury provided additional details and discussion of the 

employment incident and further substantiated her account of the July 28, 2022 employment 

incident. The injuries appellant claimed, and the initial medical treatment received, are all 

consistent with the facts and circumstances she set forth in her Form CA-1.12

There are no inconsistencies in the evidence that, cast serious doubt upon the validity of 

the claim; therefore, the Board finds that she has established a traumatic incident in the 

performance of duty on July 28, 2022, as alleged.13

As appellant has established that the July 28, 2022 employment incident factually occurred 

as alleged, the question becomes whether the incident caused an injury.14 Because OWCP found 

that she 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.15 After this and other 

such further development as deemed necessary, OWCP shall issue a de novo decision addressing 

whether appellant has met her burden of proof to establish an injury causally related to the accepted 

July 28, 2022 employment incident.16

11 Id.

12 See F.F., Docket No. 22-0266 (issued September 27, 2022); C.H., Docket No. 19-1781 (issued 

November 13, 2020).

13 C.B., Docket No. 21-0670 (issued January 27, 2022).

14 See L.O., Docket No. 20-0280 (issued October 1, 2021); M.C., supra note 10.

15 A.T., Docket No. 22-1103 (issued December 2, 2022).

16 A completed Form CA-16authorization 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 

period for which treatment is authorized by a Form CA-16 is limited to 60 days from the date of issuance, unless 

terminated earlier by OWCP. 20 C.F.R. § 10.300(c); P.R.,Docket No. 18-0737 (issued November 2, 2018);

N.M., Docket No. 17-1655 (issued January 24, 2018); Tracy P. Spillane, 54 ECAB 608 (2003).
5

CONCLUSION

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

in the performance of duty on July 28, 2022, as alleged.

ORDER

IT IS HEREBY ORDERED THAT the September 7, 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: September 20, 2023

Washington, DC

Patricia H. Fitzgerald, Deputy 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