R.A. and Department of Veterans Affairs, Audie L. Murphy Memorial Veterans’ Hospital (Board decision, March 4, 2025)

ECAB final decision. The Board affirmed denial of an injury claim because no medical evidence established a diagnosed condition. 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). FECA compensation decisions are generally not subject to court review under 5 U.S.C. § 8128(b).

Plain-English summary

A VA medical supply technician said a coworker pulled a chair into his chair during a work break, causing a possible contusion. OWCP accepted that the November 2023 incident occurred and asked for medical evidence. The worker supplied no medical records diagnosing an injury. The Board affirmed OWCP’s denial because the record did not establish a diagnosed condition connected to the incident.

Decision snapshot

• Authority: FECA; 5 U.S.C. § 8101.
• Outcome: Denial of the injury claim affirmed.
• Key point: An accepted workplace incident did not establish an injury without medical evidence of a diagnosed condition.

Full text (ECAB public release)

United States Department of Labor
Employees’ Compensation Appeals Board

________
)
R.A., Appellant
)
)
and ) Docket No. 25-0276
)
Issued: March 4, 2025
DEPARTMENT OF VETERANS AFFAIRS,
)
AUDIE L. MURPHY MEMORIAL VETERANS’ )
HOSPITAL, San Antonio, TX, Employer )
__________ )

Appearances: Case Submitted on the Record
Dr. Anthony Rogers, for the appellant1
Office of Solicitor, for the Director

DECISION AND ORDER

Before:
ALEC J. KOROMILAS, Chief Judge
PATRICIA H. FITZGERALD, Deputy Chief Judge JANICE B. ASKIN, Judge

JURISDICTION

On January 23, 2025 appellant, through his representative, filed a timely appeal from a January 3, 2025 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.
ISSUE

The issue is whether appellant has met his burden of proof to establish a diagnosed medical condition in connection with the accepted November 9, 2023 employment incident.

FACTUAL HISTORY

On October 19, 2024 appellant, then a 65-year-old medical supply aid and technician, filed a traumatic injury claim (Form CA-1) alleging that on November 9, 2023 he sustained a possible contusion when a coworker pulled a chair behind him, forcefully striking appellant’s chair while in the performance of duty. He did not stop work.

In a May 24, 2024 statement, the employing establishment controverted the claim as appellant “was on break when the alleged incident occurred.”

In an October 29, 2024 development letter, OWCP informed appellant of the deficiencies of his claim. It advised him of the type of factual and medical evidence needed to establish his claim and afforded him 60 days to submit the necessary evidence.

In a follow-up development letter dated December 4, 2024, OWCP advised appellant that it had conducted an interim review, and the evidence remained insufficient to establish his claim. It noted that he had 60 days from the October 29, 2024 letter to submit the requested supporting evidence. OWCP further advised that if the evidence was not received during this time, it would issue a decision based on the evidence contained in the record. No additional evidence was received.

By decision dated January 3, 2025, OWCP accepted that the November 9, 2023 employment incident occurred, as alleged. However, it denied appellant’s claim, finding that he had not submitted any medical evidence to establish a medical diagnosis in connection with the accepted employment incident. Consequently, OWCP found that he had not met the requirements to establish an injury as defined by FECA.

LEGAL PRECEDENT

An employee seeking benefits under FECA 3 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, 4 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

3
Id.
4
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).

2 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. There are two components involved in establishing fact of injury. First, the employee must submit sufficient evidence to establish that he or she actually experienced the employment incident at the time and place, and in the manner alleged. The second component is whether the employment incident caused an injury. 7

The medical evidence required to establish a causal relationship between a claimed specific condition and an employment incident is rationalized medical opinion evidence. 8 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 incident identified by the claimant. 9

ANALYSIS

The Board finds that appellant has not met his burden of proof to establish a diagnosed medical condition in connection with the accepted November 9, 2023 employment incident.

In development letters dated October 29 and December 4, 2024, OWCP advised appellant regarding the type of medical evidence necessary to establish his claim. However, appellant did not submit any medical evidence. As the evidence of record is insufficient to establish a diagnosed medical condition in connection with the accepted November 9, 2023 employment incident, the Board finds that he has not met his burden of proof. 10

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.

5
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 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 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). 8 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). 9 R.H., Docket No. 25-0188 (issued January 31, 2025); A.S., Docket No. 19-1955 (issued April 9, 2020); Leslie C. Moore, 52 ECAB 132 (2000). 10 M.G., Docket No. 24-0949 (issued October 22, 2024); M.S., Docket No. 24-0857 (issued September 24, 2024).

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CONCLUSION

The Board finds that appellant has not met his burden of proof to establish a diagnosed medical condition in connection with the accepted November 9, 2023 employment incident.

ORDER

IT IS HEREBY ORDERED THAT the January 3, 2025 decision of the Office of Workers’ Compensation Programs is affirmed.

Issued: March 4, 2025
Washington, DC

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

Patricia H. Fitzgerald, Deputy Chief Judge Employees’ Compensation Appeals Board

Janice B. Askin, Judge
Employees’ Compensation Appeals Board

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