L.S. and Department of the Army, Army Medical Command, Fort Rucker, AL (Board decision, September 9, 2016)

ECAB final decision. The Board affirmed OWCP’s December 22, 2015 denial of L.S.’s claimed traumatic injury. Under 20 C.F.R. § 501.6(d), this Board decision becomes final 30 days after issuance unless the Board fixed a different period in it. A party may petition the Board for reconsideration within 30 days of issuance unless this decision specifies another period, under 20 C.F.R. § 501.7(a).

Plain-English summary

L.S., an Army Medical Command employee, alleged that computer work on August 15, 2012 caused or aggravated eye symptoms. Her physician discussed dry eye and vein occlusion in general terms but did not explain how that day’s computer activity caused or worsened her specific conditions. The Board found the medical evidence insufficient to establish causation. It affirmed OWCP’s denial.

Decision snapshot

• Authority: Federal Employees’ Compensation Act, 5 U.S.C. § 8101 et seq.
• Outcome: December 22, 2015 injury denial affirmed.
• Key point: The physician did not link the claimed work event to the diagnosed eye conditions with medical reasoning.

Full text (ECAB public release)

United States Department of Labor
Employees’ Compensation Appeals Board

________
)
L.S., Appellant
)
)
and ) Docket No. 16-0921
) Issued: September 9, 2016
DEPARTMENT OF THE ARMY, ARMY
)
MEDICAL COMMAND, Fort Rucker, AL,
)
Employer
)
__________ )

Appearances: Case Submitted on the Record
Appellant, pro se
Office of Solicitor, for the Director

DECISION AND ORDER

Before:
CHRISTOPHER J. GODFREY, Chief Judge
COLLEEN DUFFY KIKO, Judge
VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On April 1, 2016 appellant filed a timely appeal from a December 22, 2015 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.

ISSUE

The issue is whether appellant met her burden of proof to establish a traumatic injury on August 15, 2012.

FACTUAL HISTORY

On February 13, 2015 appellant, then a 53-year-old personnel operation specialist, filed an occupational disease claim (Form CA-2) alleging central retinal vein occlusion with dry eye

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5 U.S.C. § 8101 et seq. as a result of working all day on a computer on August 15, 2012. She noted that, after being on sick leave from June 21 to August 14, 2012 for elevated blood pressure and central retinal vein occlusion, she returned to work on August 15, 2012. After working all day on the computer appellant stated that her eye was aching and she did not return to work on August 16, 2012. She thereafter requested to be reassigned on September 25, 2012 due to eye pain after working on the computer all day but she was told that nothing was available. Appellant became aware of her condition on June 21, 2012 and first realized its connection to her federal employment on August 15, 2012. A human resources specialist noted that appellant had retired effective September 30, 2012.

In a memorandum dated August 16, 2012, a human resources officer noted that appellant returned to work the previous day after being out 15 days. Appellant provided a note from her doctor relating that she had been seen on August 13, 2012, and could return to work on August 15, 2012. When she was informed by the employing establishment that further documentation would be needed, she advised that the documentation she had provided was all she had. Appellant also noted that she was sick, her eye was bothering her, and so she did not come to work.

By letter dated April 8, 2015, OWCP informed appellant of the evidence necessary to establish her claim. It noted that she had not submitted sufficient factual evidence to establish that her claimed injuries actually occurred, and further noted that she had not submitted sufficient medical evidence to establish her claim. OWCP afforded appellant 30 days to submit additional evidence and to respond to its inquiries.

In a report dated July 24, 2012, Dr. Warren A. Thompson, a Board-certified ophthalmologist, diagnosed central retinal vein occlusion. Appellant reported that her problem worsened when reading, writing, driving, watching television, looking at straight lines, and when she was outdoors. He recommended increasing her magnification when reading on a computer and adding artificial tears throughout the day for comfort.

By letter dated April 14, 2015, Dr. Thompson related that appellant was referred to his office on June 26, 2012 with an acute central vein occlusion in her left eye. Appellant’s initial visual acuity was able to count fingers only at six feet in the left eye and 20/20 in the right eye. Dr. Thompson explained that the risk factors for a central retinal vein occlusion are hypertension, diabetes, high cholesterol, and age. The prognosis long term was dependent on the level of perfusion in the retina. Dr. Thompson also related that appellant’s previous occupation required her to work at a computer all day. Following the development of her vein occlusion, appellant began experiencing eye strain, visual fatigue, and dry eye symptoms that caused significant pain and discomfort especially late in the workday. This was not unusual as most patients with decreased vision in one eye will blink less which exacerbates the dry eye symptoms. The treatment for this condition is the liberal use of artificial tears combined with frequent breaks to allow for adequate ocular lubrication.

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 By decision dated May 5, 2015, OWCP denied appellant’s claim for compensation. It found that she had not submitted sufficient medical evidence to establish a causal relationship between the employment factors of August 15, 2012 and her diagnosed conditions.2

Appellant submitted a letter dated September 2, 2014 from Dr. Thompson, which was identical to Dr. Thompson’s letter dated April 14, 2015.

By decision dated May 22, 2015, OWCP vacated its decision of May 5, 2015 and reopened the claim for review, because the claim had been prematurely adjudicated prior to the expiration of 30 days for submission of additional evidence.

On June 3, 2015 OWCP received a letter dated June 26, 2012, by Dr. Thompson who diagnosed central retinal vein occlusion in her left eye. Dr. Thompson noted that her long-term prognosis was very poor due to the ischemic nature of the vein occlusion.

By letter dated June 22, 2015, Dr. Thompson noted that appellant had a history of central retinal vein occlusion in her left eye and keraconjunctivitis sicca or severe dry eyes in both eyes. He noted that the vein occlusion did not cause the dry eye problem but could exacerbate the symptom because people with limited vision in one eye will often blink less while reading or working on a computer. Dr. Thompson attached general information regarding the diagnosed conditions.

By decision dated June 23, 2015, OWCP denied appellant’s claim for compensation, finding that she failed to submit sufficient medical evidence to establish a causal relationship between the work factors on August 15, 2012 and her federal employment.

On June 30, 2015 appellant requested a review of the written record before an OWCP hearing representative. She also submitted several work excuse notes from Dr. Thompson.

By decision dated December 22, 2015, OWCP’s hearing representative affirmed OWCP’s decision of June 23, 2015, finding that appellant had failed to establish that employment activities on August 15, 2012 caused or aggravated her diagnosed conditions.

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 filed within the applicable time limitation, that an injury was sustained while in the performance of duty as alleged, and that any disability and/or specific condition for which compensation is claimed are causally related to the

2
The Board notes that OWCP administratively converted appellant’s claim for an occupational disease to a claim for traumatic injury based on the description of her injury contained in the original claim Form CA-2. 3 Supra note 1.

3 employment injury.4 These are the essential elements of each and every compensation claim regardless of whether the claim is predicated on 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 a fact of injury has been established.6 First, the employee must submit sufficient evidence to establish that he actually experienced the employment incident at the time, place, and in the manner alleged.7 Second, the employee must submit sufficient evidence, generally only in the form of medical evidence, to establish that the employment incident caused a personal injury.8

The claimant has the burden of establishing by the weight of reliable, probative, and substantial evidence that the condition for which compensation is sought is causally related to a specific employment incident or to specific conditions of employment.9 An award of compensation may not be based on appellant’s belief of causal relationship. Neither the mere fact that a disease or condition manifests itself during a period of employment nor the belief that the disease or condition was caused or aggravated by employment factors or incidents is sufficient to establish a causal relationship.10

Causal relationship is a medical issue and the medical evidence generally required to establish causal relationship is rationalized medical opinion evidence.11 Rationalized medical opinion evidence is medical evidence which includes a physician’s rationalized opinion on whether there is a causal relationship between the employee’s diagnosed condition and compensable employment factors.12 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 the specific employment factors identified by the employee.13

4
C.S., Docket No. 08-1585 (issued March 3, 2009); Bonnie A. Contreras, 57 ECAB 364, 366 (2006).
5
S.P., 59 ECAB 184, 188 (2007); Joe D. Cameron, 41 ECAB 153, 157 (1989).
6
B.F., Docket No. 09-60 (issued March 17, 2009); Bonnie A. Contreras, supra note 4.
7
D.B., 58 ECAB 464, 466 (2007); David Apgar, 57 ECAB 137, 140 (2005).
8
C.B., Docket No. 08-1583 (issued December 9, 2008); D.G., 59 ECAB 734, 737 (2008); Bonnie A. Contreras, supra note 4.
9
Roma A. Mortenson-Kindschi, 57 ECAB 418, 428 n.37 (2006); Katherine J. Friday, 47 ECAB 591, 594 (1996).
10
P.K., Docket No. 08-2551 (issued June 2, 2009); Dennis M. Mascarenas, 49 ECAB 215, 218 (1997).
11
Y.J., Docket No. 08-1167 (issued October 7, 2008); A.D., 58 ECAB 149, 155-56 (2006); D’Wayne Avila, 57 ECAB 642, 649 (2006). 12 J.J., Docket No. 09-27 (issued February 10, 2009); Michael S. Mina, 57 ECAB 379, 384 (2006).
13
I.J., 59 ECAB 408, 415 (2008); Victor J. Woodhams, 41 ECAB 345, 352 (1989).

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 ANALYSIS

The Board finds that the medical evidence submitted by appellant is insufficient to establish that employment activities on August 15, 2012 caused or aggravated appellant’s diagnosed medical conditions.

Appellant submitted several letters from Dr. Thompson. In his letter dated April 14, 2015, Dr. Thompson noted, “[Appellant’s] previous occupation by report required her to work at a computer all day. Following the development of her vein occlusion, she began experiencing eye strain, visual fatigue, and dry eye symptoms that caused significant pain and discomfort especially late in the workday.” In his letter dated June 22, 2015, Dr. Thompson noted that the vein occlusion did not cause the dry eye problem, but could exacerbate the symptom because people with limited vision in one eye will often blink less while reading or working on a computer. While he explained in generalized terms the factors that could exacerbate the condition of dry eye in relation to appellant’s vein occlusion, Dr. Thompson did not offer a rationalized medical explanation as to how working on a computer on August 15, 2012 caused or aggravated appellant’s specific conditions.14

Medical evidence submitted to support a claim for compensation should reflect a correct history, and the physician should offer a medically sound explanation of how the claimed work event caused or aggravated the claimed condition.15 Lacking such an explanation, Dr. Thompson’s opinions are not sufficient to establish a causal relationship between the employment events of August 15, 2012 and appellant’s diagnosed conditions. As appellant has not submitted any rationalized medical evidence to support her allegation that she sustained an injury causally related to duties of her employment on August 15, 2012, she has not met her burden of proof to establish her claim.

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(a) and 20 C.F.R. §§ 10.605 through 10.607.

CONCLUSION

The Board finds that appellant has not met her burden of proof to establish an employment-related traumatic injury on August 15, 2012.

14
Id.
15
D.D., Docket No. 13-1517 (issued April 14, 2014).

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 ORDER

IT IS HEREBY ORDERED THAT the December 22, 2015 decision of the Office of Workers’ Compensation Programs is affirmed.

Issued: September 9, 2016
Washington, DC

Christopher J. Godfrey, Chief Judge
Employees’ Compensation Appeals Board

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge Employees’ Compensation Appeals Board

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