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United States Department of Labor
Employees’ Compensation Appeals Board
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__________________________________________
JANICE H. SLIGH,
Appellant
and
U.S. POSTAL
SERVICE, POST OFFICE, Philadelphia, PA, Employer
__________________________________________
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Docket No. 03-1621
Issued: March 31, 2004
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Appearances: Case
Submitted on the Record
Aaron S. Friedman, for the appellant
Office of the Solicitor, for the Director
DECISION AND ORDER
Before:
COLLEEN DUFFY KIKO,
Member
DAVID S. GERSON,
Alternate Member
WILLIE T.C. THOMAS,
Alternate Member
JURISDICTION
On June 9, 2003 appellant filed a timely appeal from an Office of Workers’ Compensation Programs’
decision dated May 14, 2003. Pursuant to 20 C.F.R. §§ 501(c) and 501.3,
the Board has jurisdiction over the merits of this case.
ISSUE
The issue is whether appellant met her
burden to establish that she sustained an injury in the performance of duty on November 11, 2002.
FACTUAL HISTORY
Appellant, a 47-year-old
mail handler, filed a traumatic injury claim on November 11, 2002, alleging that she sustained
multiple contusions to her head, lacerations to her lower lip and severe headaches
when she fell to the floor and hit her
head while outside of the ladies’ room on November 11, 2002. The Form CA-1 on
which appellant filed her claim stated that there were no witnesses to the
fall. The employing establishment controverted the claim on the form,
asserting that appellant sustained an idiopathic fall when she felt
light-headed, fell to the floor and did not hit anything on the way down.
On January 8, 2003 the Office advised appellant that it required
additional factual and medical evidence to determine whether she was eligible
for compensation benefits. The Office asked appellant to submit a
comprehensive medical report from her treating physician describing her
symptoms and the medical reasons for her condition, and an opinion as to
whether her claimed condition was causally related to her federal employment.
The Office requested that appellant submit the additional evidence within 30
days.
In
a response received by the Office February 4,
2003, appellant stated:
“I was coming out of [the] ladies room on [the] third
floor looking straight ahead. I proceeded to go a few yards and felt myself
getting light headed. I tried to grab hold of something. I reached out and
nothing was there to grab so I landed face first on the floor. I lost three
teeth.”
Appellant
reiterated that there were no witnesses to her fall.
In a report dated January 27, 2003, Dr. Paul H. Steinfield,
a Board-certified orthopedic surgeon, noted appellant’s history of injury and stated
that she had complaints of neck, shoulder and back pain. Dr. Steinfield
stated that x-rays demonstrated some cervical disc disease at C6-7. He
diagnosed cervical strain, paracervical periscapular myofascial pain, possible
cervical disc injury, right-sided cervical radiculopathy and low back pain. Appellant
also submitted a January 28,
2003 report from Dr. Fred A.
Stutman, a general practitioner, who noted her history of falling at work on November 11, 2002 and related her complaints of
right-sided neck, shoulder, rib, back and hip pain.
An April 21, 2003 memorandum of conference held by
the employing establishment to determine whether appellant’s fall was idiopathic
indicated that appellant denied that she had ever previously fallen in that
manner or had ever been treated for light-headedness.
In an April 25, 2003 letter, the employing
establishment stated that the Health Unit case record indicated that appellant
had been treated in the Health Unit for light-headedness on four previous
occasions: May 15,
1992, November 10, 1993, February 14 and September 19, 1995; the Health Unit records were attached
to the letter. The treatment note for November 10, 1993 indicated that appellant, upon
admission, had complained of being light-headed and related a “history of
anemia, (a) sinus problem, also states heavy menstrual flow and fainted yesterday.”
Dr. Steinfield submitted reports dated
March 3 and 17, 2003, in which he essentially reiterated his previous
findings. In his March 17,
2003 report, Dr. Steinfield
stated that appellant’s injury was work related and that she remained out of
work.
By decision dated May 14, 2003, the Office denied appellant’s
claim, finding that she failed to submit
sufficient evidence to establish that her injury occurred in the performance of
duty.
LEGAL PRECEDENT
It is a well-settled principle
of workers’ compensation law and the Board has so held that an injury resulting
from an idiopathic fall -- where a personal, nonoccupational pathology causes
an employee to collapse and to suffer injury upon striking the immediate
supporting surface and there is no intervention or contribution by any hazard
or special condition of employment -- is not within coverage of the Federal
Employees’ Compensation Act.
Such an injury does not arise out of a risk connected with the employment and
is therefore not compensable. However, as the Board has made equally clear,
the fact that the cause of a particular fall cannot be ascertained or that the
reason it occurred cannot be explained, does not establish that it was due to
an idiopathic condition.
This follows from the general
rule that an injury occurring on the industrial premises during working hours
is compensable unless the injury is established to be within an exception to
such general rule.
If the record does not establish that the particular fall was due to an
idiopathic condition, it must be considered as merely an unexplained fall, one
which is distinguishable from a fall in which it is definitely proved that a
physical condition preexisted and caused the fall.
But when the fall is unexplained, and therefore attributable neither to the
employment nor to the claimant personally, the risk is neutral, and an injury
arising in the course of employment from a neutral risk is compensable.
ANALYSIS
In this case, the medical evidence does not establish
that appellant’s fall on November 11,
2002 was due to a personal,
nonoccupational pathology. Appellant indicated that she became light-headed and
fell to the floor on November 11, 2002. There were no witnesses to the event, and appellant
did not submit any medical evidence which would indicate that the fall was causally
related to any employment-related condition or factor of employment. Although
appellant had been treated for light-headedness on four previous occasions,
approximately seven to ten years prior, the record did not contain any evidence
of a specific diagnosed condition to which this light-headedness could have
been attributable. Thus, there was no evidence in the record which provided any cause for appellant’s falling episode
on November 11, 2002. There is no sufficient evidence, therefore, to establish that a
personal, nonoccupational pathology caused appellant to fall on November 11, 2002. Accordingly, the fall in this
case remains unexplained and is therefore compensable.
CONCLUSION
The Board finds that appellant
met her burden to establish that she sustained an injury in the performance of
duty on November 11, 2002.
ORDER
IT
IS HEREBY ORDERED THAT the decision of the Office of Workers’ Compensation
Programs dated May 14, 2003 is reversed
and the case is remanded to the Office for a determination of the nature and
extent of any disability causally related to the November 11, 2002 fall.
Issued: March 31, 2004
Washington, DC
Colleen Duffy
Kiko
Member
David S. Gerson
Alternate
Member
Willie
T.C. Thomas
Alternate
Member