C.L. and Department of the Treasury, Internal Revenue Service (Board decision, May 8, 2025)

ECAB remand decision. The Board reversed OWCP's finding that no diagnosed condition was established and returned the injury claim for a decision on causation; compensation entitlement remains unresolved. 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

An IRS agent reported neck and back injuries after being rear-ended while working. An emergency physician diagnosed cervical and low-back strains after the crash. The Board found those diagnoses established a medical condition connected with the accepted incident and returned the claim for OWCP to decide causation.

Decision snapshot

• Authority: Federal Employees' Compensation Act, 5 U.S.C. § 8101 et seq.
• Outcome: Diagnosed conditions established; claim remanded for causation review.
• Key point: A physician's diagnosis after the accepted crash required OWCP to assess whether the crash caused the condition.

Full text (ECAB public release)

United States Department of Labor
Employees’ Compensation Appeals Board

________
)
C.L., Appellant
)
)
and ) Docket No. 25-0468
)
Issued: May 8, 2025
DEPARTMENT OF THE TREASURY,
)
INTERNAL REVENUE SERVICE, Austin, TX, )
Employer
)
__________ )

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

DECISION AND ORDER

Before:
PATRICIA H. FITZGERALD, Deputy Chief Judge JANICE B. ASKIN, Judge
VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On April 9, 2025 appellant filed a timely appeal from an April 7, 2025 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 his burden of proof to establish a diagnosed medical condition in connection with the accepted January 31, 2025 employment incident.

FACTUAL HISTORY

On February 3, 2025 appellant, then a 36-year-old internal revenue agent, filed a traumatic injury claim (Form CA-1) alleging that on January 31, 2025 he sustained, neck, lower

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5 U.S.C. § 8101 et seq. back, and shoulder injuries, when he was rear-ended in a motor vehicle accident (MVA) while in the performance of duty. On the reverse side of the claim form, the employing establishment acknowledged that he was injured in the performance of duty. Appellant did not stop work.

In a February 3, 2025 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 provided a questionnaire for his completion. OWCP afforded appellant 60 days to submit the necessary evidence. No response was received.

In a follow-up letter dated February 28, 2025, OWCP advised appellant that it had conducted an interim review, and the evidence remained insufficient to establish h is claim. It noted that he had 60 days from the February 3, 2025 letter to submit the necessary 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.

In a March 7, 2025 hospital emergency discharge summary, Dr. Joe Mendoza, an emergency medicine specialist, diagnosed acute cervical strain, and muscle strain of the low back following an MVA.

By decision dated April 7, 2025, OWCP accepted that the January 31, 2025 employment incident occurred, as alleged. However, it denied appellant’s claim, finding that the medical evidence of record was insufficient 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 2 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, 3 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 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 2 Id.
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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). 4 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). 5 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).

2 establish that he or she actually experienced the employment incident at the time and place, and in the manner alleged. Second, the employee must establish that the employment incident caused an injury. 6

The medical evidence required to establish causal relationship between a medical condition and an employment incident 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 the accepted employment incident. 8

ANALYSIS

The Board finds that appellant has met his burden of proof to establish a diagnosed medical condition in connection with the accepted January 31, 2025 employment incident.

In support of his claim, appellant submitted a March 7, 2025 hospital emergency department discharge summary wherein Dr. Mendoza diagnosed acute cervical strain and muscle strain of the low back sustained in an MVA. The Board thus finds that appellant has established a diagnosed medical condition in connection with the accepted January 31, 2025 employment injury.9 Consequently, the case must be remanded for consideration of the medical evidence with regard to whether appellant has met her burden of proof to establish causal relationship between his diagnosed conditions and the accepted employment incident. Following any further development as deemed necessary, OWCP shall issue a de novo decision.

CONCLUSION

The Board finds that appellant has met his burden of proof to establish a diagnosed medical condition in connection with the accepted January 31, 2025 employment incident.

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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). 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 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). 9 M.B., Docket No. 25-0307 (issued March 25, 2025); G.K., Docket No. 24-0012 (issued March 26, 2024).

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ORDER

IT IS HEREBY ORDERED THAT the April 7, 2025 merit decision of the Office of Workers’ Compensation Programs is reversed and the case is remanded for further proceedings consistent with this decision of the Board.

Issued: May 8, 2025
Washington, DC

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

Janice B. Askin, Judge
Employees’ Compensation Appeals Board

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

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