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United States Department of Labor
Employees’ Compensation Appeals Board
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___________________________________________
M.C., Appellant
and
DEPARTMENT OF THE
INTERIOR, NEW RIVER GEORGE NATIONAL RIVER,
Glen Jean, WV, Employer
___________________________________________
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Docket No. 08-1581
Issued: December
23, 2008
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Appearances: Case
Submitted on the Record
Appellant, pro se
Office of Solicitor, for the Director
DECISION AND ORDER
Before:
COLLEEN DUFFY KIKO,
Judge
MICHAEL E. GROOM,
Alternate Judge
JAMES A. HAYNES,
Alternate Judge
JURISDICTION
On May 12, 2008 appellant filed a timely appeal of a February 12,
2008 decision of the Office of Workers’ Compensation Programs’ hearing
representative, who affirmed the denial of his claim. Pursuant to 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 in establishing
that he sustained a traumatic injury in the performance of duty on December 1, 2005.
FACTUAL HISTORY
On December 18,
2005 appellant, then a 42-year-old park ranger filed a traumatic injury claim
alleging that on December 1, 2005 he sustained a lower back injury during
required physical fitness training in the performance of duty. His supervisor
stated that appellant was engaging in weight training at the time of the
claimed injury. Appellant did not stop work.
By letter
dated February 5, 2007, the Office advised appellant that additional
factual and medical evidence was needed. It explained that a physician’s
opinion was crucial to his claim and allotted 30 days to submit the requested
information.
In a
February 6, 2007 response, appellant alleged that, on December 1,
2005, he was lifting weights while on approved government physical fitness time
and using government equipment. While he was doing overhead presses of 115
pounds in a seated position, he felt a “tweek” in his lower back which caused a
sharp pain. Appellant informed Rob Tvran, his immediate supervisor, who advised
that he should file a Form CA-1. He also indicated that the immediate effects
of his injury included extreme lower back pain, which caused difficulty
walking. Appellant indicated that he had not seen a physician, with the
exception of having x‑rays taken on November 16, 2006 “for other
problems.” He indicated that his x-rays revealed degenerative changes of the
spine.
By decision
dated March 21, 2007, the Office found that the evidence supported the December 1,
2005 incident as alleged, but the medical evidence did not establish that
appellant sustained a diagnosed condition causally related to the incident.
On
April 5, 2007 appellant requested a hearing. On November 28, 2007 he
requested a review of the written record. Appellant reiterated that his lower
back injury occurred while weight lifting. He noted that he had since had
three occurrences of lower back pain which were similar to the initial injury
but did not seek medical attention.
By
decision dated February 12, 2008, the Office hearing representative
affirmed the March 21, 2007 decision.
LEGAL PRECEDENT
An employee seeking benefits under the Federal Employees’ Compensation
Act
has the burden of establishing 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 the Act, that the claim was timely filed within the
applicable time limitation period of the Act
and that an injury was sustained in the performance of duty.
These are the essential elements of each compensation claim, regardless of
whether the claim is predicated upon a traumatic injury or an occupational
disease.
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. 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.
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.
ANALYSIS
Appellant alleged that on December 1, 2005 he sustained a low back
injury during required physical fitness training in the performance of duty. The
Office accepted that appellant was engaged in authorized weight training when
the claimed injury occurred. The Board finds that the December 1, 2005
incident occurred as alleged.
The Board
finds, however, that there was no medical evidence submitted to establish that
appellant sustained a low back injury causally related to the incident of December 1, 2005.
In a letter dated February 5, 2007, the Office requested that appellant
submit medical evidence in support of his claim, including a comprehensive
medical report from a treating physician which included a diagnosis and reasoned
explanation as to how the incidents caused an injury. However, no medical
evidence was submitted.
Appellant’s
burden of proof includes the submission of rationalized medical opinion
evidence, based on a complete factual and medical background, supporting such a
causal relationship between the employment incident and the diagnosed
condition. The record contains no medical evidence. Because appellant has not
submitted medical opinion explaining how and why a diagnosed low back condition
was caused by the incident of December 1, 2005, he has not met his burden
of proof. He has failed to establish a prima facie claim for compensation.
Causal
relationship is a medical issue, and the medical evidence required to establish
causal relationship is rationalized medical evidence.
Rationalized medical opinion evidence is medical evidence which includes a
physician’s rationalized opinion on the issue of whether there is a causal relationship
between the claimant’s diagnosed condition and the implicated employment
factors.
An award of
compensation may not be based on surmise, conjecture or speculation. Neither
the fact that appellant’s condition became apparent during a period of
employment, nor the belief that his or her condition was caused, precipitated
or aggravated by his or her employment, is sufficient to establish causal
relationship.
CONCLUSION
The Board
finds that appellant has not met his burden of proof in establishing that he
sustained an injury in the performance of duty.
ORDER
IT IS HEREBY ORDERED
THAT the February 12, 2008 decision of the Office of Workers’
Compensation Programs is affirmed.
Issued: December 23, 2008
Washington, DC
Colleen
Duffy Kiko, Judge
Employees’
Compensation Appeals Board
Michael E.
Groom, Alternate Judge
Employees’
Compensation Appeals Board
James A.
Haynes, Alternate Judge
Employees’
Compensation Appeals Board