United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

W.G., Appellant

and

U.S. POSTAL SERVICE, PITTSBURGH 

PROCESSING & DISTRIBUTION CENTER, 

Pittsburgh, PA, Employer

__________________________________________

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Docket No. 23-0727

Issued: October 5, 2023

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

PATRICIA H. FITZGERALD, Deputy Chief Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On April 25, 2023 appellant, through counsel, filed a timely appeal from an April 13, 2023 

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 left foot condition 

causally related to the accepted February 19, 2020 employment incident.

FACTUAL HISTORY

This case has previously been before the Board.3 The facts and circumstances as set forth 

in the Board’s prior decision are incorporated herein by reference. The relevant facts are as 

follows.

On February 19, 2020 appellant, then a 55-year-old distribution operations supervisor, filed 

a traumatic injury claim (Form CA-1) alleging that he injured his left foot on that day when he felt 

a “pop” and instant pain in his foot when walking up two flights of stairs while in the performance 

of duty. OWCP assigned OWCP File No. xxxxxx594.4

On April 8, 2020 OWCP denied appellant’s current traumatic injury claim, finding that the 

evidence of record was insufficient to establish that the injury and/or event(s) occurred, as alleged. 

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

FECA.

Appellant requested reconsideration on April 24, 2020. With his request, he submitted a 

statement of even date in which he responded to OWCP’s development letter and described the 

alleged incident of February 19, 2020. Appellant explained that he had foot pain as a result of a 

previous injury under OWCP File No. xxxxxx569. While the current claim was a new injury, 

reports from his physicians had been submitted under OWCP File No. xxxxxx569. 

An x-ray of appellant’s left foot obtained on February 19, 2020 demonstrated lateral 

forefoot soft tissue swelling with no acute fracture. 

In a state workers’ compensation form report dated March 10, 2020, Dr. Paul Fortier, an 

internist, diagnosed a left foot injury, plantar fascial fibromatosis of the left foot, chronic pain of 

the left foot, and left foot neuropathy. He checked a box indicating that there was a preexisting 

condition contributing to appellant’s contemporaneous condition, representing an exacerbation. 

By checking another box, Dr. Fortier indicated that the incident of February 19, 2020 was a major 

contributing cause to his diagnoses. 

3 Docket No. 20-1356 (issued December 17, 2021).

4 Appellant had previously sustained a traumatic injury to his left foot on May 4, 2010 when he stepped on uneven 

pavement, which OWCP accepted for left foot sprain, ankle sprain, and plantar fibromatosis under OWCP File No. 

xxxxxx569. OWCP also accepted a recurrence of disability, effective March 19, 2013, under that claim. Appellant 

returned to limited-duty work on May 20, 2014. On February 24, 2020 he filed a notice of recurrence (Form CA-2a), 

also under OWCP File No. xxxxxx569, alleging that a recurrence of disability occurred on February 19, 2020 due to 

swelling of the foot, severe pain, and weakness. OWCP has administratively combined OWCP File Nos. xxxxxx594 

and xxxxxx569, with the former serving as the master file.
3

In a state workers’ compensation form report dated March 25, 2020, Dr. Fortier diagnosed 

plantar fascial fibromatosis of the left foot, chronic pain of the left foot, and left foot neuropathy. 

He left boxes regarding causation and aggravation unchecked. 

In a report dated March 11, 2020, Dr. Remone T. Yousif, a Board-certified pain medicine 

specialist, diagnosed plantar fasciitis, neuropathy, and plantar fascial fibromatosis of the left foot. 

Appellant stated that, 10 years prior, he experienced a work-related injury and was diagnosed with 

plantar fasciitis and plantar fascial fibromatosis. His left foot pain was exacerbated on 

February 19, 2020 when he walked upstairs and heard a “pop” in his left foot. On physical 

examination of the left foot, appellant observed a medial plantar fibroma, tenderness to palpation 

and allodynia, limited range of motion on dorsiflexion, plantar flexion, inversion, and eversion,

and a positive plantar fasciitis test. 

In a letter dated April 3, 2020, Dr. Steven Brown, an osteopathic family medicine 

specialist, stated that appellant had been under his care for a chronic left foot problem following a 

work-related injury on May 4, 2010. He noted that appellant subsequently developed neuropathic 

pain and plantar fibromatosis of the left foot. On February 19, 2020 appellant’s symptoms acutely 

worsened when he walked upstairs, heard a “pop,” and felt acute pain in the bottom of the left foot, 

restricting him from weight-bearing, and walking. On physical examination, Dr. Brown observed 

swelling in the plantar midfoot on the left with some pinkish discoloration and acute tenderness. 

He stated that it was unlikely that surgical intervention would relieve appellant’s symptoms and 

that he was totally disabled from work. 

In a state workers’ compensation form report dated May 14, 2020, Dr. Fortier diagnosed 

neuropathy and plantar fascial fibromatosis of the left foot. He left boxes regarding causation and 

aggravation unchecked. 

By decision dated June 19, 2020, OWCP denied appellant’s request for reconsideration, 

finding that the evidence submitted was insufficient to warrant merit review, pursuant to 5 U.S.C. 

§ 8128(a).

In another May 14, 2020 report, Dr. Fortier noted that he had followed up with appellant.

He diagnosed neuropathy and plantar fascial fibromatosis of the left foot.

In a note dated August 4, 2020, Dr. Brown diagnosed plantar fascia fibromatosis of both 

feet, chronic left foot pain, and neuropathic pain of the left foot. He noted that he had treated 

appellant as a patient for at least 15 years. Dr. Brown stated that appellant developed left foot pain 

after carrying mail in 2010. In 2013, appellant was diagnosed with plantar fascia tear. He returned 

to full-time work until his symptoms worsened in 2017, when weight-bearing became more 

problematic, and was given work restrictions regarding walking and standing. The symptoms 

persisted through 2018 and 2019. Dr. Brown noted that appellant’s symptoms had a component 

of diabetic nerve damage, but that appellant’s symptoms were dramatically worse on the left, 

making it unlikely that the diabetic nerve damage was the cause of his dominant symptoms. In 

February 2020, appellant’s symptoms acutely worsened after he walked upstairs and heard a “pop”

in his left foot. Dr. Brown opined that appellant had reached maximum medical improvement 

(MMI). 
4

On June 29, 2020 appellant appealed to the Board.

In a report dated August 18, 2020, Dr. Yousif diagnosed left foot neuropathy and pain. On 

physical examination of the left foot, he noted erythema in the medial aspect, tenderness over the 

dorsal aspect, and an antalgic gait with use of a cane. 

In progress notes dated May 5, 2021, Dr. Fortier followed up with appellant for left foot 

pain. Appellant stated that his condition had improved. Dr. Fortier diagnosed plantar fascial 

fibromatosis of the left foot and neuropathy. On physical examination of the left foot, he observed 

a fibrotic lump in the middle of the plantar aspect, with less tenderness compared to appellant’s 

previous visit. 

By decision dated December 17, 2021, the Board found that appellant had not met his 

burden of proof to establish a left foot condition sustained in the performance of duty on 

November 26, 2019, as alleged. However, the Board further found that the case was not in posture 

for decision as to whether OWCP properly denied appellant’s request for reconsideration of the 

merits of his claim, as OWCP had not reviewed his April 24, 2020 response to its February 26, 

2020 development letter, received prior to issuance of its June 19, 2020 decision. The Board 

remanded the case to OWCP to properly consider all evidence submitted prior to the June 19, 2020 

nonmerit decision. 

In an April 21, 2022 de novo decision, OWCP reviewed the merits of appellant’s claim and 

found that he had established that the incident of February 19, 2020 occurred as described. 

However, it denied his claim, finding that he had not submitted sufficient medical evidence to 

establish causal relationship between his diagnosed conditions and the accepted February 19, 2020 

employment incident. 

On May 3, 2022 appellant requested reconsideration. With his request, he resubmitted the 

April 3, 2020 note from Dr. Brown. Appellant also submitted a May 3, 2022 note from Dr. Brown 

to clarify the April 3, 2020 note. Dr. Brown opined that when appellant walked upstairs while in 

the performance of duty on February 19, 2020 appellant sustained a tear of the plantar fascia of 

the left foot. He noted that this was the region of appellant’s previous fibromatosis and that the 

incident was responsible for appellant’s symptoms and physical findings documented at that time 

and immediately afterward. Dr. Brown further stated that “it was this mechanism of injury and 

diagnosis that was responsible” for appellant’s continued left foot issues. 

By decision dated May 5, 2022, OWCP denied modification of its April 21, 2022 decision. 

It found that the April 3, 2020 note from Dr. Brown did not contain a rationalized medical opinion 

as to how the one-time event of walking upstairs on February 19, 2020 caused a tear of appellant’s 

left plantar fascia, given that he already had a left plantar fascial tear from a May 4, 2010 workrelated injury. OWCP further noted that Dr. Brown provided only a general and conclusory 

statement of causal relationship. 

On June 1, 2022 appellant again requested reconsideration. With his request he submitted 

a June 1, 2022 letter from Dr. Brown. Dr. Brown explained that appellant had previously suffered 

a plantar fascia tear in 2010; however, he noted that at the time of the February 19, 2020 incident, 

that tear had resolved, leaving appellant with ongoing plantar fibromatosis and plantar fasciitis. 
5

These conditions had been intermittently exacerbated, but were chronic and nonacute. Dr. Brown 

opined that the injury sustained on February 19, 2020 while walking upstairs was traumatic in 

nature and represented the acute onset of a completely new and separate plantar fasciitis tear, as 

evidenced by appellant’s sudden and acute onset of severe pain, the noted sensation of a “pop,”

and the sudden inability to bear weight. 

By decision dated August 3, 2022, OWCP denied modification of its May 5, 2022 decision. 

It found that the June 1, 2022 note from Dr. Brown was insufficiently rationalized to establish 

causal relationship between the February 19, 2020 employment incident and appellant’s diagnosed 

conditions. 

On August 4, 2022 appellant again requested reconsideration. With his request for 

reconsideration, he submitted a statement requesting OWCP review evidence in both OWCP File 

Nos. xxxxxx594 and xxxxxx569. 

By decision dated October 28, 2022, OWCP denied modification of its August 3, 2022 

decision. It found that appellant had not submitted rationalized medical evidence establishing a 

causal relationship between the February 19, 2020 incident and his diagnosed conditions. 

On April 11, 2023 appellant, through counsel requested reconsideration of OWCP’s 

October 28, 2022 decision. With his request, appellant submitted an April 5, 2023 note from

Dr. Brown, in which he explained that appellant had a well-documented history of left foot issues 

secondary to remote plantar fascia injury in 2010 and resultant fibromatosis. In 2019, he was 

examined and found to have fibromas, but no tears. Appellant was living with some degree of 

chronic pain and continued to work as of the incident of February 19, 2020. On that date, he

ascended stairs at work when he noted a “pop” sound and experienced dramatic onset of pain. 

Subsequent examination demonstrated that the plantar surface of the foot-which had welldocumented fibromas and thickening of the plantar fascia, to have increased overt swelling and a 

red-pink coloration. Appellant reached MMI in August 2020. Dr. Brown explained that, when 

appellant ascended the stairs, he placed the maximum possible stretch mechanism force on the 

baseline fibrotic plantar fascia. He noted that the foot must be dorsiflexed to reach the stair step. 

The windlass mechanism principle stated that the dorsiflexion phase of the gait winds the plantar 

fascia around the head of the metatarsal, thus increasing the tension on the fascia as it runs to the 

insertion on the calcaneus. Dr. Brown opined that the “pop” appellant heard, the acute pain he 

experienced, the notable increase in swelling with red discoloration, and finally improvement after 

prolonged rest were consistent with and indicative of longitudinal micro-tearing of the fascial 

tissue through this mechanism. 

By decision dated April 13, 2023, OWCP denied modification of its October 28, 2022 

decision. 

LEGAL PRECEDENT

An employee seeking benefits under FECA5 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 

5

Supra note 2.
6

States within the meaning of FECA, that the claim was timely filed within the applicable time 

limitation of FECA,6that 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.7 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.8

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, 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.9 

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

condition and an employment incident is rationalized medical opinion evidence. 10 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 factors 

identified by the employee.11

ANALYSIS

The Board finds that this case is not in posture for decision.

On May 3, 202 Dr. Brown opined that when appellant walked upstairs while in the 

performance of duty on February 19, 2020 appellant sustained a tear of the plantar fascia of the 

left foot. He noted that this was the region of appellant’s previous fibromatosis, and that the 

incident was responsible for appellant’s symptoms and physical findings documented at that time 

and immediately afterward. Dr. Brown further stated that this was the mechanism of injury and 

the diagnosis that was responsible for appellant’s continued left foot issues. On a June 1, 2022 he

explained that appellant had previously suffered a plantar fascia tear in 2010; however, he noted 

6 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). 

7 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).

8 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).

9 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).

10 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).

11 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).
7

that at the time of the February 19, 2020 incident, that tear had resolved, leaving appellant with 

ongoing plantar fibromatosis and plantar fasciitis. These conditions had been intermittently 

exacerbated but were chronic and nonacute. Dr. Brown opined that the injury sustained on 

February 19, 2020 while walking upstairs was traumatic in nature and represented the acute onset 

of a completely new and separate plantar fasciitis tear, as evidenced by appellant’s sudden and 

acute onset of severe pain, the noted sensation of a “pop,” and the sudden inability to bear weight. 

On April 5, 2023 he explained that appellant had a well-documented history of left foot issues 

secondary to remote plantar fascia injury in 2010 and resultant fibromatosis. In 2019, appellant 

was examined and found to have fibromas, but no tears. He was living with some degree of chronic 

pain and continued to work as of the incident of February 19, 2020. On that date, appellant

ascended stairs at work when he noted a “pop” sound and experienced dramatic onset of pain. 

Subsequent examination demonstrated that the plantar surface of the foot-which had welldocumented fibromas and thickening of the plantar fascia, to have increased overt swelling and a 

red-pink coloration. Dr. Brown explained that, when appellant ascended the stairs, he placed the 

maximum possible stretch mechanism force on the baseline fibrotic plantar fascia. He noted that 

the foot must be dorsiflexed to reach the stair step. The windlass mechanism principle stated that 

the dorsiflexion phase of the gait winds the plantar fascia around the head of the metatarsal, thus 

increasing the tension on the fascia as it runs to the insertion on the calcaneus. Dr. Brown opined 

that the “pop” appellant heard, the acute pain he experienced, the notable increase in swelling with 

red discoloration, and finally improvement after prolonged rest were consistent with and indicative 

of longitudinal micro-tearing of the fascial tissue through this mechanism.

It is well established that, proceedings under FECA are not adversarial in nature and, while 

appellant has the burden of proof to establish entitlement to compensation, OWCP shares 

responsibility in the development of the evidence.12 OWCP has an obligation to see that justice is 

done.13 

While the reports from Dr. Brown are insufficient to establish the claim, they are sufficient 

to require further development of the medical evidence.14 The case must therefore be remanded 

for further development.15

On remand, OWCP shall refer appellant to a specialist in the appropriate field of medicine. 

Its referral physician shall provide a well-rationalized opinion as to whether appellant’s diagnosed 

left foot conditions were causally related to or aggravated by the accepted employment incident of 

February 19, 2020. If the physician opines that the diagnosed conditions are not causally related, 

he or she must explain with rationale how or why the opinion differs from that of Dr. Brown. After 

12 See id. See also A.P., Docket No. 17-0813 (issued January 3, 2018); Jimmy A. Hammons, 51 ECAB 219, 

223 (1999).

13 See B.C., Docket No. 15-1853 (issued January 19, 2016); E.J., Docket No. 09-1481 (issued February 19, 2010); 

John J. Carlone, supra note 9.

14 John J. Carlone, id.; see also W.M., Docket No. 17-1244 (issued November 7, 2017); E.M., Docket No. 11-1106 

(issued December 28, 2011); Kenneth J. Deerman, 34 ECAB 641, 645 (1983).

15 J.H., supra note 7; D.S., Docket No. 17-1359 (issued May 3, 2019); X.V., Docket No. 18-1360 (issued April12, 

2019); C.M., Docket No. 17-1977 (issued January 29, 2019); William J. Cantrell, 34 ECAB 1223 (1983).
8

this and other such further development as deemed necessary, OWCP shall issue a de novo

decision.

CONCLUSION

The Board finds that this case is not in posture for decision.

ORDER

IT IS HEREBY ORDERED THAT the April 13, 2023 decision of the Office of Workers’

Compensation Programs is set aside and the case is remanded for further proceedings consistent 

with this decision of the Board.

Issued: October 5, 2023

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board