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United States Department of Labor

Employees’ Compensation Appeals Board

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M.V., Appellant

and

DEPARTMENT OF AGRICULTURE, U.S. 

FOREST SERVICE, PINE CANYON STATION, 

Santa Maria, CA, Employer

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Docket No. 19-1040

Issued: August 12, 2022

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

JANICE B. ASKIN, Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On April 10, 2019 appellant filed a timely appeal from November 14, 2018 and

February 28, 2019 merit decisions 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.

ISSUE

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

in the performance of duty on August 28, 2018, as alleged.

FACTUAL HISTORY

On August 28, 2018 appellant, then a 27-year-old forestry technician, filed a traumatic 

injury claim (Form CA-1) alleging that on that date he experienced stroke-like symptoms while in 

the performance of duty. He recounted that he was not feeling well and that a fellow crew member 

1

5 U.S.C. § 8101 et seq.
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noticed that something was wrong with him and called line medics for assistance. Appellant did 

not stop work. On the reverse side of the claim form, appellant’s supervisor indicated that 

appellant was in the performance of duty at the time of the occurrence and noted that his knowledge 

of the facts about the injury conformed with appellant’s statement.

In an August 28, 2018 transport medical record, appellant was noted to have been initially 

treated by responding paramedics for neck and head pain. It was explained that he had a threeyear history of a hemorrhagic stroke and began experiencing similar stroke-like symptoms that 

morning. 

In an August 28, 2018 emergency room record, appellant was seen by Dr. Robert Donovan, 

Board-certified in emergency medicine, who noted that appellant had been transferred to 

emergency care following the onset of a severe headache. Dr. Donovan indicated that appellant

was “working at the Donnell Fire,” where he had been camping for two days prior and awoke that 

morning with a right-sided headache and nausea. He explained that appellant had previously 

experienced a stroke in 2015 with similar symptoms. Dr. Donovan further indicated that 

computerized tomography (CT) scans of appellant’s neck and head were unremarkable and 

nothing suggested that he experienced a stroke. He diagnosed acute anxiety and an acute headache. 

In a development letter dated October 10, 2018, OWCP advised appellant of the factual 

and medical evidence necessary to establish his claim and provided a factual questionnaire

inquiring about the circumstances surrounding his claimed injury for his completion. It afforded 

him 30 days to provide the necessary information. 

In a medical report dated August 29, 2018, Dr. James Jaffe, a Board-certified radiologist, 

interpreted CT scans of appellant’s aortic arch, cervical, and intracranial vascularity which he 

indicated were normal. 

On August 31, 2018 appellant was seen by Cristina Rosales, a physician assistant, for a 

follow-up appointment. Ms. Rosales diagnosed anxiety and acute headache and reviewed his 

treatment options. Appellant also resubmitted the August 28, 2018 transportation medical record 

already of record. 

By decision dated November 14, 2018, OWCP denied appellant’s claim finding that the 

evidence of record was insufficient to establish that the August 28, 2018 employment incident

occurred as alleged. It noted that he did not provide a statement explaining how the alleged 

August 28, 2018 employment injury occurred. As such, OWCP concluded that the requirements 

had not been met to establish fact of injury as defined by FECA. 

On December 3, 2018 appellant requested reconsideration of the November 14, 2018 

decision. In support of his request, he resubmitted copies of the August 28, 2018 medical records 

previously considered by OWCP. 

OWCP also received an undated statement from C.R., appellant’s coworker. C.R. provided 

that on August 28, 2018 he noticed that appellant was quiet and was staring off into the distance. 

He noted that appellant advised that he was feeling “off” and that he was experiencing symptoms 

similar to a stroke he previously experienced. Upon hearing this, C.R. and his crew began to 

execute an emergency action plan in order to assist appellant. 
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By decision dated February 28, 2019, OWCP denied modification of the November 14, 

2018 decision. 

LEGAL PRECEDENT

An employee seeking benefits under FECA2 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 period of FECA,3that 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.4 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.5

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

performance of duty it must first be determined whether fact of injury has been established. 6 

Generally, fact of injury consists of two components that must be considered in conjunction with 

one another. 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.7 Second, the 

employee must submit sufficient evidence to establish that the employment incident caused a 

personal injury.8

ANALYSIS

The Board finds that appellant met his burden of proof to establish a traumatic injury in the 

performance of duty on August 28, 2018, as alleged. 

In his claim form, appellant alleged that he experienced an acute onset of stroke -like 

symptoms while in the performance of duty on August 28, 2018. On the reverse side of the Form 

CA-1 appellant’s supervisor acknowledged that appellant’s injury occurred in the performance of 

duty and his knowledge of the facts about the injury conformed to the statements of the employee. 

Additionally, OWCP received a statement from C.R., appellant’s coworker, who explained that on 

August 28, 2018 he noticed appellant was quiet, staring off into the distance, feeling “off” and 

2

Id.

3

J.P., Docket No. 19-0129 (issued April26, 2019); S.B., Docket No. 17-1779 (issued February 7, 2018); JoeD. 

Cameron, 41 ECAB 153 (1989).

4

J.M., Docket No. 17-0284 (issued February 7, 2018); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40 

ECAB 312 (1988).

5 R.R., Docket No. 19-0048 (issued April 25, 2019); L.M., Docket No. 13-1402 (issued February 7, 2014); 

DeloresC. Ellyett, 41 ECAB 992 (1990).

6 E.M., Docket No. 18-1599 (issued March 7, 2019); T.H., 59 ECAB 388, 393-94 (2008).

7 L.T., Docket No. 18-1603 (issued February 21, 2019); Elaine Pendleton, 40 ECAB 1143 (1989).

8 B.M., Docket No. 17-0796 (issued July 5, 2018); JohnJ. Carlone, 41 ECAB 354 (1989).
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experiencing symptoms similar to a stroke. Upon hearing this, C.R. executed an emergency action 

plan in order to assist appellant. 

Further, the history of the employment incident is recorder in the medical evidence of 

record. Specifically, Dr. Donovan observed in his August 28, 2018 medical report that appellant 

was “working at the Donnell Fire,” where he had been camping for two days when he woke up 

experiencing a headache and stroke-like symptoms. The injuries appellant claimed are consistent 

with the facts and circumstances he recounted, his course of action, and the medical evidence he 

submitted. The Board, therefore, finds that he has met his burden of proof to establish an 

employment incident in the performance of duty on August 28, 2018, as alleged.

As appellant has established that the August 28, 2018 employment incident occurred as 

alleged, the question becomes whether this incident caused a personal injury. 9 Thus, the Board 

will set aside OWCP’s February 28, 2019 decision and remand the case for consideration of the 

medical evidence. Following this and other such further development as deemed necessary, 

OWCP shall issue a de novo decision addressing whether appellant has his burden of proof to 

establish an injury causally related to the accepted August 28, 2018 employment incident. 

CONCLUSION

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

in the performance of duty on August 28, 2018, as alleged. The Board further finds that this case 

is not in posture for decision regarding whether he has established an injury causally related to the 

accepted August 28, 2018 employment incident.

9

See B.S., Docket No. 19-0524 (issued August8, 2019); Willie J. Clements, 43 ECAB 244 (1991).
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ORDER

IT IS HEREBY ORDERED THAT the February 28, 2019 and November 14, 2018 

decisions of the Office of Workers’ Compensation Programs are reversed. The case is remanded 

for further proceedings consistent with this decision of the Board.

Issued: August 12, 2022

Washington, DC

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board
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Alec J. Koromilas, Chief Judge, dissenting:

The majority finds that appellant has met his burden of proof to establish that the August 8, 

2018 employment incident occurred as alleged. I disagree.

To establish fact of injury, an employee must first submit sufficient evidence to establish 

that he or she actually experienced the employment incident at the time, place, and in the manner 

alleged.1

In his CA-1 claim form, under “cause of injury,” appellant noted “signs of stroke 

symptoms” and as to the “nature of the injury” he indicated “not feeling well, crew memb ers 

noticed something wrong.” 

Seeking further information, on October 10, 2018, OWCP advised appellant of the factual 

and medical evidence necessary to establish his claim and provided a factual questionnaire 

including specific questions inquiring about the circumstances surrounding his claimed injury for 

his completion. Appellant did not respond to OWCP’s request for additional factual information.2 

Instead, OWCP received hospital medical reports indicating normal findings including an

August 28, 2018 emergency room report from Dr. Donovan who noted that appellant had been 

transferred to emergency care following the onset of a severe headache. Dr. Donovan further 

indicated that computerized tomography (CT) scans of appellant’s neck and head were 

unremarkable and nothing suggested that he experienced a stroke. He diagnosed acute anxiety and 

an acute headache. 

On November 14, 2018 OWCP denied the claim as appellant had not responded to the 

request for factual information. 

In a request for reconsideration, appellant resubmitted medical records and a statement 

from a coworker who recounted that appellant was quiet and was staring off into the distance. The 

coworker noted that appellant advised that he was feeling “off” and that he was experiencing 

symptoms similar to a stroke he previously experienced. 

First, I would find that appellant’s CA-1 contained a limited description, if any, of the 

traumatic incident which fails to provide sufficient detail to determine the circumstances 

surrounding his injury.3

Secondly, I would find that the description of the traumatic incident by a coworker is as 

well imprecise and vague and fails to provide any specific detail or evidence establishing that the 

August 28, 2018 incident occurred as alleged4

1 L.T., Docket No. 18-1603 (issued February 21, 2019); Elaine Pendleton, 40 ECAB 1143 (1989).

2

See D.C., Docket No. 18-0082 (issued July 12, 2018); D.D., 57 ECAB 734 (2006).

3 K.S.,Docket No. 17-2001 (issued March 9, 2018).

4

See J.B., Docket No. 19-1487 (issued January 14, 2020); W.C., Docket No. 18-1651 (issued March 7, 2019); see 

also C.M., Docket No. 17-0627 (issued June 28, 2017).
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In fulfilling its responsibility to develop the claim, OWCP was very clear in its 

development letter of October 10, 2018 that it required factual information from appellant to make 

appropriate findings. Appellant did not reply as requested. In response to the initial denial, he 

again did not respond to the deficiency of the claim, that is, what actually happened on the date of 

injury. A statement was submitted by a coworker that made a very vague reference to appellant 

feeling “off” and that he was experiencing symptoms similar to a stroke he previously experienced. 

Given the type of alleged injury, such statements clearly are insufficient. In f act, they raise more 

questions regarding appellant’s stroke history which could probably be best answered by appellant. 

For OWCP to make a determination regarding whether to accept or not accept an incident requires 

information, and at minimum, the history of the surrounding events. As appellant has made no 

effort to provide OWCP with same, I must respectfully disagree with the majority finding that an 

incident occurred for the purposes of FECA

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board