I.N. and U.S. Postal Service, Post Office, Macon, GA (Board decision, July 18, 2023)

ECAB final decision. The Board affirmed OWCP's January 10, 2023 denial because no medical evidence established a diagnosed condition connected to the accepted November 18, 2022 incident. A party may petition the Board for reconsideration within 30 days of issuance unless this order specifies another period, under 20 C.F.R. § 501.7(a).

Plain-English summary

A postal carrier said metal shelving fell on her head, neck, and shoulders while she handled mail. OWCP accepted that the incident occurred, but denied the injury claim because she had not provided medical evidence identifying a condition caused by it. The Board found that no medical records had been submitted and affirmed the denial.

Decision snapshot

• Authority: FECA injury and medical proof requirements, 5 U.S.C. § 8101(5).
• Outcome: Traumatic injury claim denial affirmed.
• Key point: Proof that the incident happened did not establish a compensable injury without medical evidence of a diagnosed condition.

Full text (ECAB public release)

United States Department of Labor
Employees’ Compensation Appeals Board

________
)
I.N., Appellant
)
)
and ) Docket No. 23-0466
)
Issued: July 18, 2023
U.S. POSTAL SERVICE, POST OFFICE, )
Macon, GA, Employer
)
__________ )

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 JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On February 2, 2023 appellant filed a timely appeal from a January 10, 2023 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 her burden of proof to establish a diagnosed medical condition in connection with the accepted November 18, 2022 employment incident.

1
5 U.S.C. § 8101 et seq.
2
The Board notes that, following the issuance of OWCP’s January 10, 2023 decision, appellant submitted new 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. FACTUAL HISTORY

On November 25, 2022 appellant, then a 57-year-old letter carrier, filed a traumatic injury claim (Form CA-1) alleging that on November 18, 2022 she sustained an injury to her head and cervical spine while in the performance of duty. She explained that metal shelving fell on top of her head, back of her neck, and shoulders as she was pulling down her cased mail. Appellant indicated that she had a previous traumatic work injury related to her head and neck. On the reverse side of the claim form, appellant’s supervisor acknowledged that appellant was injured in the performance of duty.

By development letter dated December 7, 2022, OWCP indicated that the evidence provided was insufficient to establish that appellant experienced the employment incident alleged to have caused the injury. It also noted that there was no diagnosis of any condition, nor a physician’s opinion as to how the alleged injury resulted in a medical condition. A questionnaire was provided to appellant to substantiate the factual elements of her claim. Further, he was asked to provide a narrative report from a physician containing a detailed description of findings and a diagnosis, as well as a medical explanation from a physician as to how the work incident caused or aggravated a medical condition. OWCP afforded appellant 30 days to respond. No response was received.

By decision dated January 10, 2023, OWCP found that the November 18, 2022 incident had occurred as alleged, but denied appellant’s traumatic injury claim, finding that the evidence of record was insufficient to establish a diagnosed medical condition in connection with the accepted employment incident. It concluded, therefore, 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, that 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 an employee sustained a traumatic injury in the performance of duty, it must first be determined whether fact of injury has been established. There are two components involved in establishing fact of injury. The first component is whether the employee actually

3
Id. at § 8101.
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 B.H., Docket No. 20-0777 (issued October 21, 2020); K.M., Docket No. 15-1660 (issued September 16, 2016); L.M., Docket No. 13-1402 (issued February 7, 2014); Delores C. Ellyett, 41 ECAB 992 (1990).

2 experienced the employment incident that allegedly occurred. The second component is whether the employment incident caused a personal injury. 6

The medical evidence required to establish causal relationship is rationalized medical opinion evidence.7 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 incident identified by the employee. 8

ANALYSIS

The Board finds that appellant has not met her burden of proof to establish a diagnosed medical condition in connection with the accepted November 18, 2022 employment incident.

The Board notes that appellant has not submitted any medical evidence in support of her claim. As noted above, an employee seeking benefits under FECA has the burden of proof to establish the essential elements of his or her claim. To meet this burden, appellant must submit medical evidence that establishes that the employment incident caused a personal injury.9

As the evidence of record is insufficient to establish a medical diagnosis in connection with the accepted November 18, 2022 employment incident, the Board finds that appellant has not met her burden of proof.

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 a diagnosed medical condition in connection with the accepted November 18, 2022 employment incident.

6
M.H., Docket No. 18-1737 (issued March 13, 2019); John J. Carlone, 41 ECAB 354 (1989); see 5 U.S.C.
§ 8101(5) (injury defined); 20 C.F.R. §§ 10.5(ee), 10.5(q) (traumatic injury and occupational disease defined, respectively). 7 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). 8 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).
9
Supra note 3.

3
 ORDER

IT IS HEREBY ORDERED THAT the January 10, 2023 decision of the Office of Workers’ Compensation Programs is affirmed.

Issued: July 18, 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

4